Provider Demographics
NPI:1053353607
Name:EICHENBERGER, RHONDA A (DPM)
Entity type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:A
Last Name:EICHENBERGER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 825159
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-5159
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9407 WESTPORT RD STE 110
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2315
Practice Address - Country:US
Practice Address - Phone:502-797-3338
Practice Address - Fax:502-957-1731
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00296213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY80000581Medicaid
KY00452001Medicare PIN
KY80000581Medicaid