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Organization

TERRY M. ECCLES, MD, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TERRY M. ECCLES MD (OWNER/PHYSICIAN)
(860) 684-5015
Entity
Organization

Contact information

Practice address
72-LL WEST STAFFORD ROAD, STAFFORD SPRINGS, CT 06076
(860) 684-5015
(860) 684-3749
Mailing address
72-LL WEST STAFFORD ROAD, STAFFORD SPRINGS, CT 06076
(860) 684-5015
(860) 684-3749

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
037680
CT
363LF0000X
Family Nurse Practitioner
005863
CT

Other

Enumeration date
07/26/2011
Last updated
11/17/2014
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