Provider Demographics
NPI:1902917727
Name:ATWOOD, ERIC B (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:B
Last Name:ATWOOD
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 1:1200 SCHWEGLER DR RM 2100
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66045-7538
Mailing Address - Country:US
Mailing Address - Phone:785-864-2277
Mailing Address - Fax:785-864-2721
Practice Address - Street 1:1200 SCHWEGLER DR RM 2100
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66045-1963
Practice Address - Country:US
Practice Address - Phone:785-864-2277
Practice Address - Fax:785-864-2721
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5219532084P0804X
KS05-219532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSE99985Medicare UPIN
KS294570Medicaid