Healthcare Provider Details

I. General information

NPI: 1568585081
Provider Name (Legal Business Name): ALLEN JOSEPH ECKHOFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 04/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 LAUREL ST SUITE 3170
DES MOINES IA
50314-3005
US

IV. Provider business mailing address

411 LAUREL ST SUITE 3170
DES MOINES IA
50314-3017
US

V. Phone/Fax

Practice location:
  • Phone: 515-245-6425
  • Fax: 515-283-0794
Mailing address:
  • Phone: 515-245-6425
  • Fax: 515-283-0794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number57.023992
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD42437
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: