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General NPI Number Information
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NPI Number | 1013108661
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Entity Type | Individual
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Provider Name | ALEXIS ANN ECKARD MD
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Gender | Female
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | 255 W 5TH STREET SUITE 300
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City | ROME
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State | GA
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Zip | 30165
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Country | US
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Telephone | 706-509-5000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 865
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City | WINCHESTER
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State | TN
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Zip | 37398-0865
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Country | US
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Telephone | 615-849-8861
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Fax | 931-967-6606
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 42922
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 061577
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License Number State | GA
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