Provider Demographics
NPI:1124465265
Name:EICHLER, ADAM JEFFERY (DMD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:JEFFERY
Last Name:EICHLER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 WHITNEY OAKS DR
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-6060
Mailing Address - Country:US
Mailing Address - Phone:210-722-7168
Mailing Address - Fax:
Practice Address - Street 1:301 FISHER ST
Practice Address - Street 2:KEESLER AIR FORCE BASE
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39534
Practice Address - Country:US
Practice Address - Phone:210-722-7168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS039580122300000X, 204E00000X
MS4396-231223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery