Individual
DR. JEREMIAH W EAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
802 JEFFERSON AVE, SCRANTON, PA 18510-1038
(570) 348-0360
(570) 348-0362
Mailing address
802 JEFFERSON AVE, SCRANTON, PA 18510-1038
(570) 348-0360
(570) 348-0362
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD-021443-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1187399
—
PA
01
—
815507
FIRST PRIORITY
PA
01
—
851436
BLUE SHEILD
PA
Enumeration date
06/14/2005
Last updated
04/23/2014
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