Provider Demographics
NPI:1255910253
Name:ECKES, MELISSA BROOKE (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:BROOKE
Last Name:ECKES
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 1:4301 W MARKHAM
Mailing Address - Street 2:SLOT 520
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7199
Mailing Address - Country:US
Mailing Address - Phone:501-686-6627
Mailing Address - Fax:501-686-5696
Practice Address - Street 1:4301 W MARKHAM
Practice Address - Street 2:SLOT 520
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-686-6627
Practice Address - Fax:501-686-5696
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program