Provider Demographics
NPI:1952133035
Name:DAVID J. EILBOTT, MD, PLLC
Entity type:Organization
Organization Name:DAVID J. EILBOTT, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:EILBOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-430-4368
Mailing Address - Street 1:5 PEQUOT PARK RD STE 201A
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06498-2856
Mailing Address - Country:US
Mailing Address - Phone:203-430-4368
Mailing Address - Fax:
Practice Address - Street 1:5 PEQUOT PARK RD STE 201A
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:CT
Practice Address - Zip Code:06498-2856
Practice Address - Country:US
Practice Address - Phone:203-430-4368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty