Healthcare Provider Details

I. General information

NPI: 1437808839
Provider Name (Legal Business Name): ERIC DALTON DEIG DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 N ELM ST
HENDERSON KY
42420-2938
US

IV. Provider business mailing address

736 N ELM ST
HENDERSON KY
42420-2938
US

V. Phone/Fax

Practice location:
  • Phone: 270-827-7199
  • Fax: 270-827-7376
Mailing address:
  • Phone: 270-827-7199
  • Fax: 270-827-7376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number297050
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: