Individual
DR. THOMAS STANFORD EAGAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
215 COUNTY HIGHWAY 128, GLOVERSVILLE, NY 12078-4806
(518) 773-7306
(518) 773-8511
Mailing address
215 COUNTY HIGHWAY 128, GLOVERSVILLE, NY 12078-4806
(518) 773-7306
(518) 773-8511
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
1162791
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000420268001
BSNENY
NY
05
—
00527239
—
NY
01
—
1162791
WC
NY
Enumeration date
10/28/2005
Last updated
07/08/2007
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