Provider Demographics
NPI:1821143223
Name:EATON, DARREN R (DC)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:R
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:508-823-2697
Practice Address - Street 1:575 SOUTH ST W
Practice Address - Street 2:SUITE 2
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-5305
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:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACH2581111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY36867OtherBC BS
MA352453OtherHARVARD PILGRIM
MAY36867OtherBC BS
MAU76528Medicare UPIN