Individual
FAYE EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
682 HEMLOCK ST, SUITE 290, MACON, GA 31201-6883
(478) 743-8052
(478) 743-0035
Mailing address
682 HEMLOCK ST, SUITE 290, MACON, GA 31201-6883
(478) 743-8052
(478) 743-0035
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
16176
GA
208000000X
Pediatrics Physician
26744
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000155075B
—
GA
Enumeration date
10/02/2006
Last updated
06/16/2011
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