Provider Demographics
NPI:1518589399
Name:ERIC TODER, D.O.
Entity Type:Organization
Organization Name:ERIC TODER, D.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:TODER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-384-8450
Mailing Address - Street 1:7381 W CHARLESTON BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1571
Mailing Address - Country:US
Mailing Address - Phone:702-384-8450
Mailing Address - Fax:702-366-1220
Practice Address - Street 1:7381 W CHARLESTON BLVD STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1571
Practice Address - Country:US
Practice Address - Phone:702-384-8450
Practice Address - Fax:702-366-1220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty