Provider Demographics
NPI:1437585163
Name:ECKEL, STEPHEN MYLES (OD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:MYLES
Last Name:ECKEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8316 MEDICAL PLAZA DR
Mailing Address - Street 2:STE. E
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-6702
Mailing Address - Country:US
Mailing Address - Phone:704-547-1551
Mailing Address - Fax:704-548-8017
Practice Address - Street 1:7148 LAWYERS RD
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-3906
Practice Address - Country:US
Practice Address - Phone:704-535-9252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2325152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist