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General NPI Number Information
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NPI Number | 1447394523
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Entity Type | Organization
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Legal Business Name | ECKER PLASTIC SURGERY ASSOC INC
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 10/21/2008
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Provider Practice Location Address
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Address Line | 920 WASHINGTON BLVD
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City | WILLIAMSPORT
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State | PA
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Zip | 17701
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Country | US
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Telephone | 570-322-4779
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Fax | 570-322-3196
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Provider Business Mailing Address
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Address Line | 920 WASHINGTON BLVD
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City | WILLIAMSPORT
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State | PA
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Zip | 17701
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Country | US
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Telephone | 570-322-4779
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Fax | 570-322-3196
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HERBERT A ECKER JR.
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Credential | M.D.
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Telephone | 570-322-4779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | MD021034E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | MD021034E
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License Number State | PA
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