Provider Demographics
NPI:1407026479
Name:EATON, SAMUEL HAMILTON (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:HAMILTON
Last Name:EATON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:75 NEWMAN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02916-3603
Mailing Address - Country:US
Mailing Address - Phone:401-854-2465
Mailing Address - Fax:401-435-7019
Practice Address - Street 1:23 POWEL AVE APT 3
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-2679
Practice Address - Country:US
Practice Address - Phone:401-228-0631
Practice Address - Fax:401-324-5025
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.127589208800000X
NC2013-01407208800000X
RIMD17170208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology