Individual
DR. DENNIS LEE ECKELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O., F.A.A.F.P.
Contact information
Practice address
238 INDIANA ST, SEWARD, PA 15954-2055
(814) 446-5695
(814) 446-4209
Mailing address
PO BOX 486, SEWARD, PA 15954-0486
(814) 446-5695
(814) 446-4209
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS-003436-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00150773800/01
—
PA
01
—
01586199
BLUE CROSS/BLUE SHIELD
PA
01
—
100236
UPMC HEALTH PLAN
PA
01
—
207QOOOOOX
TAXONOMY CODE
PA
01
—
255520
HEALTH ASSURANCE
PA
01
—
4556169
AETNA PROVIDER #
PA
01
—
56-24-90789
TAX ID
PA
01
—
56-2490789
UMWA ID
PA
01
—
DD1268
MEDICARE RAILROAD GROUP#
PA
01
—
OS-003436-L
PA STATE LICENSE
PA
01
—
P00209792
MEDICARE RAILROAD INDIVID
PA
Enumeration date
06/16/2006
Last updated
04/30/2008
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