Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 35. 093231 | OH |
N | 207R00000X | Internist | 35 093231 | OH |
N | 111NI0900X | Internist | 35 093231 | OH |
N | 207R00000X | Internist | D62806 | MD |
N | 111NI0900X | Internist | D62806 | MD |
N | 207RA0201X | Internist - Allergy & Immunology | D62806 | MD |
NPI | 1083774327 |
---|---|
Provider Name | John A Eckman |
First Address | Montgomery, OH 45242-4472 |
Second Address | Montgomery, OH 45242-4472 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2006 |
Last Update Date | 06/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
409289900 | (05) | MD |
EC4268931 | MEDICARE PTAN (01) | OH |
I35139 | (02) | MD |