Provider Demographics
NPI:1760829246
Name:ECKLUND, LAURA CHRISTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:CHRISTINE
Last Name:ECKLUND
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-333-4104
Mailing Address - Fax:704-358-4544
Practice Address - Street 1:2711 RANDOLPH ROAD
Practice Address - Street 2:SUITE 512
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207
Practice Address - Country:US
Practice Address - Phone:704-333-4104
Practice Address - Fax:704-358-4544
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC191580207V00000X
NC2017-00866207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology