Individual
JACINTA CATHERINE EICKHOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3224 JARVIS RD, LIMA, OH 45807-2213
(419) 996-5757
(419) 996-5913
Mailing address
PO BOX 636930, CINCINNATI, OH 45263-0001
(513) 981-5123
(513) 981-5015
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11014499A
IN
207Q00000X
Family Medicine Physician
Primary
35.099945
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0074054
—
OH
Enumeration date
06/09/2008
Last updated
07/26/2021
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