Provider Demographics
NPI:1831178201
Name:EIFLER, ERIC A (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:A
Last Name:EIFLER
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 1:2900 W RAY RD STE 5
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-7342
Mailing Address - Country:US
Mailing Address - Phone:480-659-7147
Mailing Address - Fax:877-785-4849
Practice Address - Street 1:2900 W RAY RD STE 5
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-7342
Practice Address - Country:US
Practice Address - Phone:480-659-7147
Practice Address - Fax:877-785-4849
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0460207X00000X, 207XX0005X
AZ30630207XS0114X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB117560OtherMEDICARE PART B EFFECT 02/01/2011
AZ30630OtherSATE MED BOARD
TX100885605Medicaid
TX6484850005OtherMEDICARE NSC EFFECT 02/01/2011
TX8CR144OtherBCBS TX 02/01/2011
TXP00469012OtherRAILROAD MEDICARE
TX1831178201OtherNPI
TX8X5840OtherBCBS TEXAS NUMBER
TXP00913295OtherRAILROAD MEDICARE EFFECT 02/01/2011
AZ30630OtherSATE MED BOARD
TX6484850005OtherMEDICARE NSC EFFECT 02/01/2011
AZ47-1091815OtherTAX ID
TX8CR144OtherBCBS TX 02/01/2011