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General NPI Number Information
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NPI Number | 1619038171
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Entity Type | Individual
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Provider Name | WILLIAM LAURENCE ECKSTEIN MD
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Gender | Male
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 205 N TILLOTSON AVE
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City | MUNCIE
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State | IN
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Zip | 47304-3900
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Country | US
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Telephone | 765-291-5437
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Fax | 765-751-9114
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Provider Business Mailing Address
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Address Line | 240 N TILLOTSON AVE
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City | MUNCIE
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State | IN
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Zip | 47304-3988
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Country | US
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Telephone | 765-288-1928
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Fax | 765-741-0310
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036066126
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0109455A
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License Number State | IN
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