Provider Demographics
NPI:1588027320
Name:ECKELBARGER, DAVID LAWRENCE (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LAWRENCE
Last Name:ECKELBARGER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 UNIVERSITY OF NEW MEXICO # 105590
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-2345
Mailing Address - Fax:505-272-2374
Practice Address - Street 1:1 UNIVERSITY OF NEW MEXICO # 105590
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-2824
Practice Address - Country:US
Practice Address - Phone:505-272-2345
Practice Address - Fax:505-272-2374
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRS2025-0043390200000X
TXBP10055742208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208600000XAllopathic & Osteopathic PhysiciansSurgery