Provider Demographics
NPI:1063599777
Name:ECKERT, JAMES ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALAN
Last Name:ECKERT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:598 W MAIN ST
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-5342
Mailing Address - Country:US
Mailing Address - Phone:860-889-1475
Mailing Address - Fax:860-889-2850
Practice Address - Street 1:598 W MAIN ST
Practice Address - Street 2:SUITE ONE
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-5342
Practice Address - Country:US
Practice Address - Phone:860-889-1475
Practice Address - Fax:860-889-2850
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT913111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTT01350Medicare UPIN