Provider Demographics
NPI:1376698761
Name:EATON, SHAWN F (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:F
Last Name:EATON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 DEAN ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2717
Mailing Address - Country:US
Mailing Address - Phone:508-823-2697
Mailing Address - Fax:508-824-4559
Practice Address - Street 1:109 DEAN ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2717
Practice Address - Country:US
Practice Address - Phone:508-823-2697
Practice Address - Fax:508-824-4559
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACH1983111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY36497OtherBC BS
MA351312OtherHARVARD PILGRIM
MA776828OtherTUFTS
MAY45142Medicare ID - Type Unspecified
MA776828OtherTUFTS