Provider Demographics
NPI:1598726143
Name:EAKIN, DAVID II (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:EAKIN
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 S DENVER AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-3423
Mailing Address - Country:US
Mailing Address - Phone:918-808-2473
Mailing Address - Fax:918-608-1047
Practice Address - Street 1:1408 S DENVER AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-3423
Practice Address - Country:US
Practice Address - Phone:918-808-2473
Practice Address - Fax:918-608-1047
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK219622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200023860AMedicaid
OKI05693Medicare UPIN
OK241417301Medicare ID - Type Unspecified