Provider Demographics
NPI:1821149956
Name:ECKMAN, JAMES ROBERT JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:ECKMAN
Suffix:JR
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 1:300 WHITNEY ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:DOWAGIAC
Mailing Address - State:MI
Mailing Address - Zip Code:49047-1672
Mailing Address - Country:US
Mailing Address - Phone:269-782-1144
Mailing Address - Fax:269-782-1145
Practice Address - Street 1:300 WHITNEY ST
Practice Address - Street 2:SUITE A
Practice Address - City:DOWAGIAC
Practice Address - State:MI
Practice Address - Zip Code:49047-1672
Practice Address - Country:US
Practice Address - Phone:269-782-1144
Practice Address - Fax:269-782-1145
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008329111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4361261Medicaid
MI950A450100OtherBCBS OF MI
MI950A450100OtherBCBS OF MI
MIU84478Medicare UPIN