Provider Demographics
NPI:1568441095
Name:CARKNER, ERIC (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:CARKNER
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 1:830 BOYLSTON ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-2503
Mailing Address - Country:US
Mailing Address - Phone:617-734-2450
Mailing Address - Fax:617-734-7804
Practice Address - Street 1:830 BOYLSTON ST
Practice Address - Street 2:SUITE 211
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-2503
Practice Address - Country:US
Practice Address - Phone:617-734-2450
Practice Address - Fax:617-734-7804
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219099207XS0117X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2106388Medicaid
MAA38938Medicare ID - Type Unspecified