Provider Demographics
NPI:1518907104
Name:ECKERT, THOMAS F (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:F
Last Name:ECKERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1440
Mailing Address - Country:US
Mailing Address - Phone:814-375-4200
Mailing Address - Fax:814-375-4232
Practice Address - Street 1:100 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1440
Practice Address - Country:US
Practice Address - Phone:814-371-2200
Practice Address - Fax:814-375-3384
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0082352207L00000X
PAMD-051302-L207L00000X
NJ25MA05866900207L00000X
NV13544207L00000X
CT054171207L00000X
NY284527207L00000X
WY10198A207L00000X
VA0101228768207L00000X
WAMD 60628120207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01555323Medicaid
NJ01555323Medicaid
NJ815272MY8Medicare ID - Type Unspecified