Provider Demographics
NPI:1922117183
Name:EYMAN, JAMES RANDALL (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RANDALL
Last Name:EYMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2955 SW WANAMAKER DRIVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614
Mailing Address - Country:US
Mailing Address - Phone:785-272-5566
Mailing Address - Fax:785-272-5967
Practice Address - Street 1:2955 SW WANAMAKER DRIVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614
Practice Address - Country:US
Practice Address - Phone:785-272-5566
Practice Address - Fax:785-272-5967
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS656103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS4957140801Medicaid
013303Medicare ID - Type Unspecified