Individual
RAYETTA EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1101 JACKSON ST SW, GRAVETTE, AR 72736-9121
(479) 787-5291
(479) 344-6404
Mailing address
1101 JACKSON ST SW, GRAVETTE, AR 72736-9121
(479) 787-5291
(479) 344-6404
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-1070
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130593001
—
AR
01
—
5K334
BLUE CROSS
AR
Enumeration date
05/23/2006
Last updated
08/15/2019
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