Individual
SCOTT ECCARIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
631 SAINT ANNE ST, SUITE 103, RAPID CITY, SD 57701-4678
(605) 343-4120
Mailing address
631 SAINT ANNE ST, SUITE 103, RAPID CITY, SD 57701-4678
(605) 343-4120
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
SD3450
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6300422
—
SD
01
—
S2468
MEDICARE PTAN
—
Enumeration date
05/30/2006
Last updated
12/06/2016
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