Provider Demographics
NPI:1649203159
Name:JAMES R. EAKIN O.D. PLLC
Entity Type:Organization
Organization Name:JAMES R. EAKIN O.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:EAKIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:603-524-3085
Mailing Address - Street 1:PO BOX 1325
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-1325
Mailing Address - Country:US
Mailing Address - Phone:603-524-3085
Mailing Address - Fax:603-524-2789
Practice Address - Street 1:366 UNION AVE
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-2812
Practice Address - Country:US
Practice Address - Phone:603-524-3085
Practice Address - Fax:603-524-2789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH257152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNA1171OtherHARVARD PILGRIM
NH3076909Medicaid
NH2260860OtherCIGNA
NH0907777Y0NH02OtherBLUECROSS BLUESHIELD
NH2260860OtherCIGNA
NH0907777Y0NH02OtherBLUECROSS BLUESHIELD