MEDICARE: JAMES MICHAEL ELECZKO LAC

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	171100000X	Acupuncturist	577	NC

General Provider Information

NPI Number	:	1790047199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES MICHAEL ELECZKO LAC

Provider Business Mailing Address
First Line	:	3948 BROWNING PL STE 204
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-6512
Country	:	US
Telephone Number	:	919-260-4104
Fax Number	:	919-400-4232

Provider Business Practice Location Address
First Line	:	3948 BROWNING PL STE 204
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-6512
Country	:	US
Telephone Number	:	919-260-4104
Fax Number	:	919-400-4232

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

Provider Enumeration Date	:	06/12/2012
Last Update Date	:	07/17/2025

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