Provider Demographics
NPI:1427210442
Name:ECHOLS, CARMEN (MD)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:ECHOLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5910 HILLANDALE DR
Mailing Address - Street 2:SUIRE 301
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-1884
Mailing Address - Country:US
Mailing Address - Phone:770-987-2155
Mailing Address - Fax:
Practice Address - Street 1:5910 HILLANDALE DR
Practice Address - Street 2:SUITE 301
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-1884
Practice Address - Country:US
Practice Address - Phone:770-987-2155
Practice Address - Fax:770-323-2675
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002955207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine