Charles F Eddingfield MD
Organization Active NPI General Practice Physician · Keokuk, IA
NPI 1639250293 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1639250293
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 18836 (IA)
- Legal business name
- CHARLES F EDDINGFIELD MD
- Practice address
- 1610 Morgan Street
Keokuk, IA 52632 - Phone
- (319) 524-7777
- Fax
- (319) 524-7782
- NPI assigned
- Oct 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Charles F Eddingfield, MD
- Title
- Owner
- Phone
- (319) 524-7777
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Charles F Eddingfield MD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | 18836 | IA | Yes |
Addresses
Primary practice location
1610 Morgan Street
Keokuk, IA 52632
Mailing address
1610 Morgan Street
Keokuk, IA 52632
Phone (319) 524-7777
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0089458 | Medicaid | IA |
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All providers in Keokuk, IA · General Practice Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.