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Individual

DR. JAMES ALAN EICKELMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1163
CO
152W00000X
Optometrist
497
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0452890003
MEDICARE DMERC
NM
05
08116394
CO
05
28378261
NM
01
410046891
RAILROAD MEDICARE
CO
01
608439600
US DEP LAB WORK COMP
CO
01
920725020820
EYE SPECIALIST
CO
01
CO1163
EYEMED EYECARE
CO
01
EIE0596
ANTHEM BCBS
CO
01
NM00PA58
NM BCBS
NM
Enumeration date
05/10/2006
Last updated
12/05/2012
Update your record

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