Healthcare Provider Details

I. General information

NPI: 1992716419
Provider Name (Legal Business Name): KAROLYNN T ECHOLS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 08/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 CHESTNUT ST 1ST FLOOR
PHILADELPHIA PA
19107-4414
US

IV. Provider business mailing address

833 CHESTNUT ST 1ST FLOOR
PHILADELPHIA PA
19107-4414
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-5000
  • Fax: 215-923-1089
Mailing address:
  • Phone: 215-955-5000
  • Fax: 215-923-1089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number78634
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMA08141000
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number25MA08141000
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD457698
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: