Individual
ERIC A GIEBELHAUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 W MORTON AVE, JACKSONVILLE, IL 62650-2623
(217) 245-6814
(217) 245-0375
Mailing address
2020 W ILES AVE, SPRINGFIELD, IL 62704-7015
(217) 698-3030
(217) 698-4728
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036051855
IL
207W00000X
Ophthalmology Physician
Primary
036051855
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036051855
—
IL
Enumeration date
07/04/2006
Last updated
01/14/2014
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