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General NPI Number Information
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NPI Number | 1821085572
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Entity Type | Individual
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Provider Name | TIMOTHY BRAINERD ECKEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 255 LOCUST LN
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City | DANVILLE
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State | PA
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Zip | 17821-8561
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Country | US
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Telephone | 570-275-6153
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Fax | 570-258-8808
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Provider Business Mailing Address
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Address Line | 255 LOCUST LN
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City | DANVILLE
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State | PA
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Zip | 17821-8561
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Country | US
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Telephone | 570-275-6153
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Fax | 570-258-8808
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD019417E
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License Number State | PA
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