Provider Demographics
NPI:1417900010
Name:EICKHOFF, JAMES ARTHUR (OD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ARTHUR
Last Name:EICKHOFF
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 TIMBER WAY CT
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-1824
Mailing Address - Country:US
Mailing Address - Phone:410-526-5776
Mailing Address - Fax:
Practice Address - Street 1:310 MAIN ST
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-1904
Practice Address - Country:US
Practice Address - Phone:410-833-5515
Practice Address - Fax:410-833-7131
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0684152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD39949501OtherCAREFIRST BCBS
MDU02932Medicare UPIN
MD0326600001Medicare NSC
MD39949501OtherCAREFIRST BCBS