Provider Demographics
NPI:1841374618
Name:JOHN A EGLI MD PC
Entity type:Organization
Organization Name:JOHN A EGLI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:EGLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:260-593-2902
Mailing Address - Street 1:PO BOX 698
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:IN
Mailing Address - Zip Code:46571
Mailing Address - Country:US
Mailing Address - Phone:260-593-2902
Mailing Address - Fax:260-593-3492
Practice Address - Street 1:315 LEHMAN AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:IN
Practice Address - Zip Code:46571
Practice Address - Country:US
Practice Address - Phone:260-593-2902
Practice Address - Fax:260-593-3492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN153870Medicare Oscar/Certification