Individual
ERIC R SOUTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6000 N BAILEY AVE, AMHERST, NY 14226-5102
(716) 834-4266
(716) 834-6255
Mailing address
6000 N BAILEY AVE, AMHERST, NY 14226-5102
(716) 834-4266
(716) 834-6255
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
184767
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010170803
UNIVERA
NY
01
—
000511558004
BC/BS
NY
05
—
01355022
—
NY
01
—
040426001983
FIDELIS
NY
01
—
0409761
IHA
NY
01
—
145445BJ
PREFERRED CARE
NY
Enumeration date
01/11/2006
Last updated
07/23/2014
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