Provider Demographics
NPI:1386050904
Name:ERIC A EIFLER MD, PLLC
Entity type:Organization
Organization Name:ERIC A EIFLER MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:EIFLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-659-7147
Mailing Address - Street 1:2900 W RAY RD STE 5
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-7342
Mailing Address - Country:US
Mailing Address - Phone:480-659-7147
Mailing Address - Fax:877-785-4849
Practice Address - Street 1:2900 W RAY RD STE 5
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-7342
Practice Address - Country:US
Practice Address - Phone:480-659-7147
Practice Address - Fax:877-785-4849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30630207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ30630OtherSTATE LIC
AZ30630OtherSTATE LIC