Individual
JENNIFER L EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
9500 EUCLID AVE FL 8, CLEVELAND, OH 44195-1030
(800) 223-2273
Mailing address
9500 EUCLID AVE FL 8, CLEVELAND, OH 44195-0001
(800) 223-2273
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
1672
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010212444
TAX ID #
ME
01
—
041311
ANTHEM
ME
01
—
04Y002540ME01
ANTHEM
NH
01
—
1376528398
GROUP NPI#
—
01
—
1649364233
INDIVIDUAL NPI #
ME
05
—
289440099
—
ME
01
—
MM9730
MEDICARE GROUP #
ME
Enumeration date
10/03/2006
Last updated
07/15/2022
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