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NPI Code Detail

MEDICARE: CHARLES ERIC ECKMAN M.D.

MEDICARE: CHARLES ERIC ECKMAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician12332OK
2208VP0014XInterventional Pain Medicine Physician12332OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003817743
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES ERIC ECKMAN M.D.
Provider Business Mailing Address
First Line : 6608 N WESTERN AVE #422
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73116
Country : US
Telephone Number : 405-775-9350
Fax Number :
Provider Business Practice Location Address
First Line : 14101 PARKWAY COMMONS
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73134-6012
Country : US
Telephone Number : 405-749-6277
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2005
Last Update Date : 04/01/2014

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