Provider Demographics
NPI:1386534634
Name:EUBANKS, ANTHONY CHASE (NP)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:CHASE
Last Name:EUBANKS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 LLOYD EUBANKS RD
Mailing Address - Street 2:
Mailing Address - City:LUCEDALE
Mailing Address - State:MS
Mailing Address - Zip Code:39452
Mailing Address - Country:US
Mailing Address - Phone:601-394-7179
Mailing Address - Fax:
Practice Address - Street 1:5912 OLD MOBILE AVE STE 1
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39581-4520
Practice Address - Country:US
Practice Address - Phone:228-762-4642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS907400363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health