Eidolon Medical Services PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

EIDOLON MEDICAL SERVICES PLLC

Practice address

1056 Eagleridge Blvd
Pueblo, CO 81008-2159

Phone

(719) 568-0815

Fax

(719) 631-2564

NPI assigned

Jul 1, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eric Edgerton Blom, MDNPI 1295784916

Title

Managing Member

Phone

(719) 252-7734

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric E Blom, MD

  • Ophthalmology Physician
  • Colorado Springs, CO
  • NPI 1295784916
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1770329633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9243",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810089243",
            "telephone_number": "719-252-7734",
            "fax_number": "719-631-2564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1056 EAGLERIDGE BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082159",
            "telephone_number": "719-568-0815",
            "fax_number": "719-631-2564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EIDOLON MEDICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "BLOM",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "EDGERTON",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "719-252-7734",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eh Hospice of Colorado, LLC
• Anthony Ehlen
• Dayna Ellen Ehlers, DPT, PT
• Elizabeth A Ehrhardt, MD
• James Alan Eickelman, O.D.
• Suhaib El Khatib
• El Pueblo Boys' and Girls' Ranch, Inc.
• Sonia El-Kweifi
• Judith D. Elder, L.P.C.
• Jacquelyn L Eleson, DNAP, CRNA

• Ophthalmology Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Ophthalmology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.