Provider Demographics
NPI:1043216815
Name:EICKELBERG, STEVEN JAMES (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAMES
Last Name:EICKELBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6316 E ARABIAN WAY
Mailing Address - Street 2:STE 1
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-1815
Mailing Address - Country:US
Mailing Address - Phone:480-922-1991
Mailing Address - Fax:480-922-1362
Practice Address - Street 1:6316 E ARABIAN WAY
Practice Address - Street 2:STE 1
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-1815
Practice Address - Country:US
Practice Address - Phone:480-922-1991
Practice Address - Fax:480-922-1362
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ227532084P0800X, 2084P0802X, 2084S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Not Answered2084S0010XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySports Medicine