Provider Demographics
NPI:1104896059
Name:EAGON, CATHERINE L (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:L
Last Name:EAGON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1719 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-2104
Mailing Address - Country:US
Mailing Address - Phone:724-226-2128
Mailing Address - Fax:724-226-2498
Practice Address - Street 1:1719 UNION AVE
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-2104
Practice Address - Country:US
Practice Address - Phone:724-226-2128
Practice Address - Fax:724-226-2498
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070193L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018158700002Medicaid
PACG1496Medicare PIN
PA0018158700002Medicaid
PA039681R7RMedicare PIN
PAH20503Medicare UPIN