Provider Demographics
NPI:1114209301
Name:EKWO, ANTHONY CHUKA (MD MPH)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:CHUKA
Last Name:EKWO
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1498 MARCASITE DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-3517
Mailing Address - Country:US
Mailing Address - Phone:347-963-1865
Mailing Address - Fax:
Practice Address - Street 1:RUTH CLINIC
Practice Address - Street 2:1300 HATCHER LANE
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401
Practice Address - Country:US
Practice Address - Phone:931-548-3177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMDST 7582084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry