NPI 1447262456

Robert D Reisenberg, PA

Practitioner Physician Assistant Medford, WI

Practice location

Address: 143 S Gibson St, Medford, WI 54451-1622
Phone: (715) 748-2121
Fax: (715) 748-7590
Mailing address: 143 South Gibson Street, Medford, WI 54451-1622

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 196 (WI)

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Registry record

NPI: 1447262456
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Aug 2006
Record last updated: 14 May 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.