Provider Demographics
NPI:1477605665
Name:ECKERT, WILLIAM MERRITT (CRNA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:MERRITT
Last Name:ECKERT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6080 CRESTONE ST
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-1016
Mailing Address - Country:US
Mailing Address - Phone:530-368-7655
Mailing Address - Fax:
Practice Address - Street 1:55 MADISON ST
Practice Address - Street 2:STE 200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5419
Practice Address - Country:US
Practice Address - Phone:303-388-0599
Practice Address - Fax:303-388-9805
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1015367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
R99261Medicare UPIN