Provider Demographics
NPI:1881846947
Name:EATON, CAROL SUE (MPA, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:SUE
Last Name:EATON
Suffix:
Gender:F
Credentials:MPA, PA-C
Other - Prefix:
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Mailing Address - Street 1:300 SINGLETON RIDGE RD
Mailing Address - Street 2:ATTENTION PATIENT ACCOUNTING
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-9142
Mailing Address - Country:US
Mailing Address - Phone:843-234-6946
Mailing Address - Fax:843-234-8958
Practice Address - Street 1:903 BELL ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-4113
Practice Address - Country:US
Practice Address - Phone:843-488-2111
Practice Address - Fax:843-448-2112
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC2312363AM0700X
GA005454363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant