Doctor Name: | DR. JOHN DOUGLAS EBERSOLE |
NPI Number: | 1023185287 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 4301074124 |
Business Practice Address: | Bronson Methodist Hospital 601 John Street Kalamazoo, MI - 49007 |
Business Phone Number: | 2693416411 |
Business Fax Number: | |
Mailing Address: | 1506 N Custer Ave, CLAWSON |
State: | MI |
Postal Code: | 480171106 |
Phone Number: | 2485068064 |
Fax Number: | |
NPI Enumeration Date: | 11/30/2006 |
NPI Last Update Date: | 10/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 4301074124 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |