Basic Information
| Provider Information | |||||||||
| NPI: | 1255316527 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EICHENBERGER | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 HIGHLANDER POINT DR | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | FLOYDS KNOBS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 471199465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8129234106 | ||||||||
| FaxNumber: | 8129234100 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 HIGHLANDER POINT DR | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | FLOYDS KNOBS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 471199465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8129234106 | ||||||||
| FaxNumber: | 8129234100 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/09/2005 | ||||||||
| LastUpdateDate: | 01/02/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 01039624 | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | 01039624 | IN | N | Allopathic & Osteopathic Physicians | Pediatrics | 208M00000X | 01039624A | IN | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 100425730A | 05 | IN | MEDICAID |