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General NPI Number Information
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NPI Number | 1609096692
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Entity Type | Individual
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Provider Name | MARY ANN ECK PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2108 E 3RD ST STE 200
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City | CHATTANOOGA
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State | TN
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Zip | 37404-2624
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Country | US
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Telephone | 423-267-0466
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Fax | 423-493-2371
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Provider Business Mailing Address
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Address Line | 979 E 3RD ST STE 300
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City | CHATTANOOGA
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State | TN
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Zip | 37403-2187
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Country | US
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Telephone | 423-267-0466
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Fax | 423-493-2371
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2539
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-00986
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License Number State | NC
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