Provider Demographics
NPI:1972203636
Name:ECKERLE DODDRIDGE, LEANN MARIE (PHARMD, BCPS)
Entity type:Individual
Prefix:
First Name:LEANN
Middle Name:MARIE
Last Name:ECKERLE DODDRIDGE
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 STATE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-6802
Mailing Address - Country:US
Mailing Address - Phone:812-948-7674
Mailing Address - Fax:812-948-7684
Practice Address - Street 1:1919 STATE ST STE 100
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-6802
Practice Address - Country:US
Practice Address - Phone:812-948-7674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26020127A1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care