Individual
COY EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12523
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110147876
RR MEDICARE
SC
05
—
125233
—
SC
01
—
P01505888
RAILROAD MEDICARE
SC
Enumeration date
02/28/2006
Last updated
06/17/2021
Update your record
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