Provider Demographics
NPI:1255316527
Name:EICHENBERGER, DANIEL J (MD)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
Last Name:EICHENBERGER
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:800 HIGHLANDER POINT DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-9465
Mailing Address - Country:US
Mailing Address - Phone:812-923-4106
Mailing Address - Fax:812-923-4100
Practice Address - Street 1:800 HIGHLANDER POINT DR
Practice Address - Street 2:SUITE 300
Practice Address - City:FLOYDS KNOBS
Practice Address - State:IN
Practice Address - Zip Code:47119-9465
Practice Address - Country:US
Practice Address - Phone:812-923-4106
Practice Address - Fax:812-923-4100
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01039624207R00000X, 208000000X
IN01039624A208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100425730AMedicaid
IN243940AMedicare ID - Type Unspecified
IN100425730AMedicaid