Provider Demographics
NPI:1821097668
Name:GERKEN, ERIC S (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:S
Last Name:GERKEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 COLLEGE PKWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-4882
Mailing Address - Country:US
Mailing Address - Phone:239-482-0300
Mailing Address - Fax:239-482-4757
Practice Address - Street 1:8801 COLLEGE PKWY
Practice Address - Street 2:SUITE 2
Practice Address - City:FT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-4882
Practice Address - Country:US
Practice Address - Phone:239-482-0300
Practice Address - Fax:239-482-4757
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004589111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22164Medicare ID - Type Unspecified
FLT94011Medicare UPIN