Healthcare Provider Details

I. General information

NPI: 1043216815
Provider Name (Legal Business Name): STEVEN JAMES EICKELBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6316 E ARABIAN WAY STE 1
PARADISE VALLEY AZ
85253-1815
US

IV. Provider business mailing address

6316 E ARABIAN WAY STE 1
PARADISE VALLEY AZ
85253-1815
US

V. Phone/Fax

Practice location:
  • Phone: 480-922-1991
  • Fax: 480-922-1362
Mailing address:
  • Phone: 480-922-1991
  • Fax: 480-922-1362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number22753
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number22753
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code2084S0010X
TaxonomySports Medicine (Psychiatry & Neurology) Physician
License Number22753
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: