Provider Demographics
NPI:1992843189
Name:EADS, WILLIAM STUART (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:STUART
Last Name:EADS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:W.
Other - Middle Name:STUART
Other - Last Name:EADS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1230 CUMBERLAND FALLS HWY
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-2717
Mailing Address - Country:US
Mailing Address - Phone:606-528-0138
Mailing Address - Fax:
Practice Address - Street 1:1230 CUMBERLAND FALLS HWY
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2717
Practice Address - Country:US
Practice Address - Phone:606-528-0138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY19694207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000047409OtherANTHEM
KY64196942Medicaid
KY4510OtherCHA
KYC08002OtherCUMBERLAND HEALTHCARE INC
KY1263023OtherUMWA
KYV610989885001OtherBLUEGRASS FAMILY HEALTH
KY1325201Medicare ID - Type Unspecified
KYV610989885001OtherBLUEGRASS FAMILY HEALTH