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NPI Code Detail

MEDICARE: LYNN GORDON ECKERT PA-C

MEDICARE: LYNN GORDON ECKERT PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant101608NC

General Provider Information

NPI Number : 1275585168
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNN GORDON ECKERT PA-C
Provider Business Mailing Address
First Line : 2340 SPRING FOREST RD
Second Line :
City : RALEIGH
State : NC
Zip : 27615-7528
Country : US
Telephone Number : 612-225-1538
Fax Number : 612-225-1591
Provider Business Practice Location Address
First Line : 2340 SPRING FOREST RD
Second Line :
City : RALEIGH
State : NC
Zip : 27615-7528
Country : US
Telephone Number : 612-225-1538
Fax Number : 612-225-1591
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 08/13/2009

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Directions to “ LYNN GORDON ECKERT PA-C” Practice Location

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