MEDICARE: STEVEN JAMES EICKELBERG 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
1	2084P0800X	Psychiatry Physician	22753	AZ
2	2084P0802X	Addiction Psychiatry Physician	22753	AZ
3	2084S0010X	Sports Medicine (Psychiatry & Neurology) Physician	22753	AZ

General Provider Information

NPI Number	:	1043216815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN JAMES EICKELBERG M.D.

Provider Business Mailing Address
First Line	:	6316 E ARABIAN WAY
Second Line	:	STE 1
City	:	PARADISE VALLEY
State	:	AZ
Zip	:	85253-1815
Country	:	US
Telephone Number	:	480-922-1991
Fax Number	:	480-922-1362

Provider Business Practice Location Address
First Line	:	6316 E ARABIAN WAY
Second Line	:	STE 1
City	:	PARADISE VALLEY
State	:	AZ
Zip	:	85253-1815
Country	:	US
Telephone Number	:	480-922-1991
Fax Number	:	480-922-1362

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	09/11/2025

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