Basic Information
Provider Information
NPI: 1225422108
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EICHHORN
FirstName: JOSHUA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 251420
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722251420
CountryCode: US
TelephoneNumber: 5016868000
FaxNumber:  
Practice Location
Address1: 4301 W MARKHAM ST
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722057101
CountryCode: US
TelephoneNumber: 5016865356
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/27/2015
LastUpdateDate: 08/31/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/31/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XE-12111ARN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2085N0904XE-12111ARY Allopathic & Osteopathic PhysiciansRadiologyNuclear Radiology

No ID Information.


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