Provider Demographics
NPI:1265583827
Name:EATON, JOHN DAVID (MD MPH)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:EATON
Suffix:
Gender:M
Credentials:MD MPH
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5004 HIGHWAY 69 N
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35473-2039
Mailing Address - Country:US
Mailing Address - Phone:205-339-2499
Mailing Address - Fax:205-339-6422
Practice Address - Street 1:5004 HIGHWAY 69 N
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-2039
Practice Address - Country:US
Practice Address - Phone:205-339-2499
Practice Address - Fax:205-339-6422
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000153922083X0100X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL25776CASMedicare ID - Type Unspecified
E46999Medicare UPIN