Provider Demographics
NPI:1124049564
Name:EISINGER, LAWRENCE F (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:F
Last Name:EISINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 SOUTH CASCADE STREET
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-2813
Mailing Address - Country:US
Mailing Address - Phone:218-736-8000
Mailing Address - Fax:218-736-8757
Practice Address - Street 1:712 SOUTH CASCADE STREET
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2813
Practice Address - Country:US
Practice Address - Phone:218-736-8000
Practice Address - Fax:218-736-8757
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN23513208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNCMA7610129Medicaid
MN61166EIOtherBCBS NUMBER
MNHP26507OtherHEALTHPARTNERS NUMBER
MN114376OtherUCARE NUMBER
NE41091744413Medicaid
ND10717Medicaid
IL4109174445353701Medicaid
IA0561449Medicaid
MN733892900Medicaid
MN1008969OtherPREFERRED ONE NUMBER
MN12-00187OtherMEDICA NUMBER
D48529Medicare UPIN
MN733892900Medicaid
MN1008969OtherPREFERRED ONE NUMBER
IL4109174445353701Medicaid