Provider Demographics
NPI:1578773974
Name:ECHOLS, LEON FORREST III (RPH)
Entity Type:Individual
Prefix:MR
First Name:LEON
Middle Name:FORREST
Last Name:ECHOLS
Suffix:III
Gender:M
Credentials:RPH
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Mailing Address - Street 1:147 GLEN EAGLE WAY
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-4230
Mailing Address - Country:US
Mailing Address - Phone:770-474-3520
Mailing Address - Fax:770-474-3520
Practice Address - Street 1:1920 HUDSON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-5038
Practice Address - Country:US
Practice Address - Phone:770-507-1234
Practice Address - Fax:770-507-1011
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GA012506183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist