Giebelhausen, Eric A

Giebelhausen, Eric A is an individual health care provider with primary practice located at 2000 W Morton Ave , Jacksonville IL 62650-2623. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Giebelhausen, Eric A can be contacted via phone (217) 245-6814.

Contact Information

Primary practice address
2000 W Morton Ave Jacksonville IL 62650-2623
Phone: (217) 245-6814
Fax: (217) 245-0375
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 036051855 Illinois
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036051855 Illinois

Profile Details

NPI number 1790715662
LBN Legal business name Giebelhausen, Eric A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 4th, 2006
Last updated Jan 14th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790715662 NPPES
Illinois MEDICAID 036051855

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