Healthcare Provider Details

I. General information

NPI: 1669577854
Provider Name (Legal Business Name): MARTHA L EICHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 W INA RD
TUCSON AZ
85704-6204
US

IV. Provider business mailing address

655 E RIVER RD
TUCSON AZ
85704-5840
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-8100
  • Fax: 520-694-8191
Mailing address:
  • Phone: 520-694-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24039
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: