Provider Demographics
NPI:1124218698
Name:EITZEN, JOHN POINTER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:POINTER
Last Name:EITZEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:806 S MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-5282
Mailing Address - Country:US
Mailing Address - Phone:308-532-3937
Mailing Address - Fax:308-532-2838
Practice Address - Street 1:806 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-5282
Practice Address - Country:US
Practice Address - Phone:308-532-3937
Practice Address - Fax:308-532-2838
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13382207W00000X
MDD71351207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology