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Contact Information

TERRY M. ECCLES, MD, LLC
72-LL WEST STAFFORD ROAD
STAFFORD SPRINGS, CT06076
 Phone: 860-684-5015
 Fax: 860-684-3749
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for TERRY M. ECCLES, MD, LLC

NPI # 1952689945
LBN Legal business name TERRY M. ECCLES, MD, LLC
Authorized official TERRY ECCLES - (OWNER/PHYSICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 07/26/2011
Last updated 11/17/2014 - About 12 years ago
Identifiers
CT License # 005863
CT License # 037680
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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