Provider Demographics
NPI:1639266844
Name:JOHN J. EICHENLAUB, MD, P.C.
Entity Type:Organization
Organization Name:JOHN J. EICHENLAUB, MD, P.C.
Other - Org Name:DRS. EICHENLAUB & MAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:EICHENLAUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-509-5090
Mailing Address - Street 1:2128 EMBASSY DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-2385
Mailing Address - Country:US
Mailing Address - Phone:717-509-5090
Mailing Address - Fax:717-509-5078
Practice Address - Street 1:2128 EMBASSY DR
Practice Address - Street 2:SUITE B
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2385
Practice Address - Country:US
Practice Address - Phone:717-509-5090
Practice Address - Fax:717-509-5078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050033L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA082498Medicare ID - Type UnspecifiedDRS.EICHENLAUB & MAY CORP