Provider Demographics
NPI:1902890643
Name:ECKRICH, JOHN D (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:ECKRICH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7345 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-4405
Mailing Address - Country:US
Mailing Address - Phone:314-752-7100
Mailing Address - Fax:314-752-3284
Practice Address - Street 1:7345 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-4405
Practice Address - Country:US
Practice Address - Phone:314-752-7100
Practice Address - Fax:314-752-3284
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-08
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR6244207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA11528Medicare UPIN