Provider Demographics
NPI:1386414035
Name:ECP PROFESSIONALS LLC
Entity type:Organization
Organization Name:ECP PROFESSIONALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:PINGREE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:385-330-0358
Mailing Address - Street 1:5091 N PONY RIDER WAY
Mailing Address - Street 2:
Mailing Address - City:EAGLE MTN
Mailing Address - State:UT
Mailing Address - Zip Code:84005-5379
Mailing Address - Country:US
Mailing Address - Phone:385-330-0358
Mailing Address - Fax:
Practice Address - Street 1:5091 N PONY RIDER WAY
Practice Address - Street 2:
Practice Address - City:EAGLE MTN
Practice Address - State:UT
Practice Address - Zip Code:84005-5379
Practice Address - Country:US
Practice Address - Phone:385-330-0358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty