Connor Thomas Eckholdt, MD

Student in an Organized Health Care Education/Training Program in Shreveport, LA. Individual provider (NPI-1).

NPI number1194352831

StatusActive

Last updated in NPPESMar 24, 2020

Details

NPI: 1194352831
Entity type: Individual (NPI-1)
Name: Connor Thomas Eckholdt
Credential: MD
Sex: Male
Sole proprietor: Yes
Enumeration date: Mar 24, 2020
Certification date: Mar 24, 2020
Last updated: Mar 24, 2020

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
390200000X	Student in an Organized Health Care Education/Training Program	–	–	Yes

Practice location

1501 Kings Hwy # Surgery
Shreveport, LA 71103-4228

Phone 318-626-0617

Mailing address

1501 Kings Hwy # Surgery
Shreveport, LA 71103-4228

Phone 318-626-0617

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Student in an Organized Health Care Education/Training Program providers in Shreveport, LA

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