Provider Demographics
NPI:1881697787
Name:ECKER, RICHARD I (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:I
Last Name:ECKER
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 1:706 NE EVANS ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-3926
Mailing Address - Country:US
Mailing Address - Phone:503-472-1405
Mailing Address - Fax:503-434-5950
Practice Address - Street 1:706 NE EVANS ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-3926
Practice Address - Country:US
Practice Address - Phone:503-472-1405
Practice Address - Fax:503-434-5950
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD11786207N00000X, 207NS0135X, 207ND0101X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR287583OtherOMAP
OR5512000OtherBLUE CROSS OF OR
OR168823OtherOMAP
ORR0000BHKMSOtherMEDICARE ID
OR5512000OtherBLUE CROSS OF OR