Provider Demographics
NPI:1922079953
Name:EICKHOFF, ERIC S (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:S
Last Name:EICKHOFF
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNMC PHYSICIANS
Mailing Address - Street 2:42ND AND EMILE
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-1150
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UNMC PHYSICIANS
Practice Address - Street 2:42ND AND EMILE
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-1150
Practice Address - Country:US
Practice Address - Phone:402-559-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE117100363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEQ34678Medicare UPIN
NE278562Medicare ID - Type Unspecified