Provider Demographics
NPI:1730443698
Name:ECHOLS, ROGER MADISON (MD)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:MADISON
Last Name:ECHOLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:753 WESTPORT RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06612-1535
Mailing Address - Country:US
Mailing Address - Phone:203-292-5516
Mailing Address - Fax:
Practice Address - Street 1:753 WESTPORT RD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:CT
Practice Address - Zip Code:06612-1535
Practice Address - Country:US
Practice Address - Phone:203-292-5516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT032098207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease