Provider Demographics
NPI:1972565695
Name:ECKEL, DENNIS (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:ECKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 N WYATT DR STE 260
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6118
Mailing Address - Country:US
Mailing Address - Phone:520-795-0608
Mailing Address - Fax:520-795-0354
Practice Address - Street 1:5111 N SCOTTSDALE RD STE 143
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-7076
Practice Address - Country:US
Practice Address - Phone:480-945-6583
Practice Address - Fax:480-945-0359
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17215174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ4050100OtherCIGNA
AZ277584OtherMERCY CARE
AZAZ0254060OtherBLUE CROSS BLUE SHIELD
AZ277584OtherAHCCCS
AZ1Z2040OtherHEALTHNET
AZ1Z2040OtherHEALTHNET
AZZWCLFM02Medicare ID - Type Unspecified