Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 01030362A | IN |
N | 111NI0900X | Internist | 01030362A | IN |
Y | 207RG0100X | Gastroenterologist | 01030362 | IN |
NPI | 1053347856 |
---|---|
Provider Name | Thomas C Eckert |
First Address | Evansville, IN 47732-3395 |
Second Address | Madison, IN 47250 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 20/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000042200 | ANTHEM BCBS (01) | IN |
100204710A | (05) | IN |
1065583 | PASSPORT (01) | KY |
2434507000 | PASSPORT ADVANTAGE (01) | KY |
268222 | FEDERAL BLACK LUNG (01) | |
42200 | ANTHEM (01) | IN |
4414242 | AETNA (01) | |
4414242 | AETNA (01) | IN |
64757289 | (05) | KY |
B28865 | (02) |