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NPI Code Detail

MEDICARE: DEAN A. ECKERT M.D.

MEDICARE: DEAN A. ECKERT 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
1207R00000XInternal Medicine Physician22704KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000042997OTHERKYANTHEM B/C & B/S UPIN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31167804OTHERKYCHA HEALTH

General Provider Information

NPI Number : 1750389847
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEAN A. ECKERT M.D.
Provider Business Mailing Address
First Line : 2050 VERSAILLES RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-1405
Country : US
Telephone Number : 859-254-5701
Fax Number : 859-367-7138
Provider Business Practice Location Address
First Line : 2050 VERSAILLES RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-1405
Country : US
Telephone Number : 859-254-5701
Fax Number : 859-367-7138
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 01/30/2014

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Directions to “ DEAN A. ECKERT M.D.” Practice Location

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