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Individual

DR. STEPHEN W. EAKIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1280A MAIN ST, ALTAVISTA, VA 24517-1465
(434) 309-1165
Mailing address
1204 FENWICK DR, LYNCHBURG, VA 24502-2112

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101042725
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010215072
VA PREMIER
05
010215072
VA
01
186412
ANTHEM PROVIDER NUMBER
01
203639329
UNITED HEALTHCARE PROVIDE
01
203639329013
TRICARE PROVIDER NUMBER
01
329078
SOUTHERN HEALTH PROVIDER
01
45207
SENTARA/OPTIMA PROVIDER N
01
47475
MEDCOST PROVIDER NUMBER
01
700010640
CIGNA PROVIDER NUMBER
Enumeration date
06/30/2005
Last updated
03/04/2011
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