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Individual

JUSTIN JAMES EGGLESTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
201 STATE ST, HAMOT EMERGENCY ROOM, ERIE, PA 16550-0002
(814) 877-6139
(814) 877-6093
Mailing address
717 STATE ST, SUITE 16, LL, ERIE, PA 16501-1341
(814) 480-7100
(814) 480-7604

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS011861
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00026790801
UNIVERA
NY
01
02593433
NY MEDICAL ASSISTANCE
NY
05
1011365700001
PA
01
1068837
W. VIRGINIA WORKERS COMP
WV
01
1537945
GATEWAY
PA
01
156601
UNISON
PA
01
1625163
BLUE SHIELD
PA
01
2484753
OH MEDICAL ASSISTANCE
OH
01
410043
UPMC
PA
01
7895534
AETNA
PA
01
P00147174
RR MEDICARE
PA
Enumeration date
07/26/2005
Last updated
05/05/2008
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