MEDICARE: DR. J SCOTT ECKELS DDS MS ORTHODONTIST

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	3299	WV

General Provider Information

NPI Number	:	1821177957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. J SCOTT ECKELS DDS MS ORTHODONTIST

Provider Business Mailing Address
First Line	:	2010 GARFIELD AVE STE 1
Second Line	:
City	:	PARKERSBURG
State	:	WV
Zip	:	26101-2527
Country	:	US
Telephone Number	:	304-422-6477
Fax Number	:	304-865-2048

Provider Business Practice Location Address
First Line	:	2010 GARFIELD AVE STE 1
Second Line	:
City	:	PARKERSBURG
State	:	WV
Zip	:	26101-2527
Country	:	US
Telephone Number	:	304-422-6477
Fax Number	:	304-865-2048

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	10/31/2018

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