Individual
DR. JOHN M EAGLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
441 GREEN RD, MADISON, IN 47250-2645
(812) 273-2020
(812) 273-4022
Mailing address
441 GREEN RD, MADISON, IN 47250-2645
(812) 273-5889
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001655A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100148590
—
IN
05
—
200233640
—
IN
Enumeration date
07/18/2005
Last updated
10/04/2018
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