Individual
DR. STANLEY BOYD EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3193 HOWELL MILL RD NW, SUITE 110, ATLANTA, GA 30327-2119
(404) 355-7591
(404) 355-9175
Mailing address
3480 PRESTON RIDGE RD STE 600, CREDENTIALING DEPARTMENT, ALPHARETTA, GA 30005-5462
(770) 300-0101
(770) 300-0429
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
011703
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000942235G
—
GA
05
—
000942235S
—
GA
01
—
202G708830
RAILROAD MEDICARE
GA
01
—
300042145
RAILROAD MEDICARE
GA
01
—
300045215
RAILROAD MEDICARE
GA
01
—
300122058
RAILROAD MEDICARE
GA
01
—
300122059
RAILROAD MEDICARE
GA
01
—
P00244508
RAILROAD MEDICARE
GA
Enumeration date
12/05/2005
Last updated
10/02/2009
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