Provider Demographics
NPI:1598728826
Name:EICHERT, STEPHEN J (DO)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:J
Last Name:EICHERT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 SW MULVANE ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1764
Mailing Address - Country:US
Mailing Address - Phone:785-354-9591
Mailing Address - Fax:785-368-0478
Practice Address - Street 1:823 SW MULVANE ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1764
Practice Address - Country:US
Practice Address - Phone:785-354-9591
Practice Address - Fax:785-368-0478
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE4270207T00000X
OH34.008915207T00000X
KS05-30889207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR155814003Medicaid
KS201097870AMedicaid
OH2725788Medicaid
ARP00226398OtherRAILROAD MEDICARE
AR05060013400OtherQUALCHOICE
KS068002257OtherMEDICARE PTAN
ARP00226398OtherRAILROAD MEDICARE
ARE45349Medicare UPIN
OH2725788Medicaid