Provider Demographics
NPI:1912161985
Name:ECKBERG, DAVID JOHN (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:ECKBERG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1922 MT ZION DR
Mailing Address - Street 2:C/O L&J HENEFELD
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-1736
Mailing Address - Country:US
Mailing Address - Phone:720-840-4545
Mailing Address - Fax:
Practice Address - Street 1:1922 MT ZION DR
Practice Address - Street 2:C/O L&J HENEFELD
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-1736
Practice Address - Country:US
Practice Address - Phone:720-840-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32393207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology