Basic Information
| Provider Information | |||||||||
| NPI: | 1285745190 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DELMAN | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | BENJAMIN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 MT CARMEL WAY | ||||||||
| Address2: | |||||||||
| City: | PITTSBURG | ||||||||
| State: | KS | ||||||||
| PostalCode: | 667627587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202357605 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1 MED CENTER CIR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | PITTSBURG | ||||||||
| State: | KS | ||||||||
| PostalCode: | 667626740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202357605 | ||||||||
| FaxNumber: | 6202357609 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 02/01/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 20A8917 | CA | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 05-38435 | KS | Y | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 5911 | OK | N | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 00AX89170 | 05 | CA | MEDICAID | 20-3799368 | 01 | FEDERAL TAX ID | OTHER | 20A8917 | 01 | CA | STATE MEDICAL LISCENCE | OTHER |