Healthcare Provider Details

I. General information

NPI: 1053353607
Provider Name (Legal Business Name): RHONDA A EICHENBERGER DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9407 WESTPORT RD STE 110
LOUISVILLE KY
40241-2315
US

IV. Provider business mailing address

PO BOX 825159
PHILADELPHIA PA
19182-5159
US

V. Phone/Fax

Practice location:
  • Phone: 502-797-3338
  • Fax: 502-957-1731
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00296
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: