MEDICARE: CALEB ALAN EGGENBERGER DO

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	207P00000X	Emergency Medicine Physician	02008845A	IN
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1194466870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALEB ALAN EGGENBERGER DO

Provider Business Mailing Address
First Line	:	205 N EAST AVE
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49201-1753
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1316 E 7TH ST
Second Line	:
City	:	AUBURN
State	:	IN
Zip	:	46706-2538
Country	:	US
Telephone Number	:	260-925-4600
Fax Number	:

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

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	03/20/2026

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