Provider Demographics
NPI:1902979008
Name:ECKFORD, JOHN F (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:ECKFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-1032
Mailing Address - Country:US
Mailing Address - Phone:512-509-8500
Mailing Address - Fax:
Practice Address - Street 1:300 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-1032
Practice Address - Country:US
Practice Address - Phone:512-509-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7718208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1639619-02Medicaid
TX8W0855OtherBC/BS OF TEXAS
TX8W0855OtherBC/BS OF TEXAS
TXP003156655Medicare PIN
TX1639619-02Medicaid
TX8F4423Medicare PIN
TX8F2248Medicare PIN
TX8F4428Medicare PIN
TX102359Medicare UPIN
TX8F2251Medicare PIN