Eclavea, Anthony

Eclavea, Anthony is an individual health care provider with primary practice located at 1818 N Meade St , Appleton WI 54911-3454. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Eclavea, Anthony can be contacted via phone (920) 739-5642.

Contact Information

Primary practice address
1818 N Meade St Appleton WI 54911-3454
Phone: (920) 739-5642
Fax: (920) 886-0430
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 50367 Wisconsin
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 50367 Wisconsin

Profile Details

NPI number 1447319702
LBN Legal business name Eclavea, Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2006
Last updated Aug 19th, 2010 - about 16 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 1447319702 NPPES
Wisconsin MEDICAID 34785300

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