Provider Demographics
NPI:1346219284
Name:EAKER, JAMES RONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RONALD
Last Name:EAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:J
Other - Middle Name:RON
Other - Last Name:EAKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1303 DANTIGNAC ST
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2775
Mailing Address - Country:US
Mailing Address - Phone:706-733-4427
Mailing Address - Fax:706-737-0215
Practice Address - Street 1:1303 DANTIGNAC ST
Practice Address - Street 2:SUITE 2500
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2775
Practice Address - Country:US
Practice Address - Phone:706-733-4427
Practice Address - Fax:706-737-0215
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA028538207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA160012470OtherRAILROAD MEDICARE
GA10057966OtherAMERIGROUP
GA338015OtherWELLCARE
GA137377112AMedicaid
GA408119940AMedicare PIN
GA10057966OtherAMERIGROUP