Basic Information
| Provider Information | |||||||||
| NPI: | 1598728826 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EICHERT | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 823 SW MULVANE ST | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666061764 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7853549591 | ||||||||
| FaxNumber: | 7853680478 | ||||||||
| Practice Location | |||||||||
| Address1: | 823 SW MULVANE ST | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666061764 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7853549591 | ||||||||
| FaxNumber: | 7853680478 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2006 | ||||||||
| LastUpdateDate: | 08/18/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | E4270 | AR | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 34.008915 | OH | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 05-30889 | KS | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 155814003 | 05 | AR | MEDICAID | 201097870A | 05 | KS | MEDICAID | 2725788 | 05 | OH | MEDICAID | P00226398 | 01 | AR | RAILROAD MEDICARE | OTHER | 05060013400 | 01 | AR | QUALCHOICE | OTHER | 068002257 | 01 | KS | MEDICARE PTAN | OTHER |