Provider Demographics
NPI:1477549293
Name:ECKMAN, JAMES B JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:B
Last Name:ECKMAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 950248
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0248
Mailing Address - Country:US
Mailing Address - Phone:502-253-1035
Mailing Address - Fax:502-253-1037
Practice Address - Street 1:4003 KRESGE WAY
Practice Address - Street 2:SUITE 115
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4652
Practice Address - Country:US
Practice Address - Phone:502-897-8163
Practice Address - Fax:502-897-8052
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2020-12-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN010377982085R0001X
KY246742085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64246747Medicaid
KY000000638805OtherANTHEM
KY50026471OtherPASSPORT
KY50026471OtherPASSPORT
KYC78459Medicare UPIN