Provider Demographics
NPI:1295768646
Name:EATON, JAMES M (M D)
Entity type:Individual
Prefix:
First Name:JAMES M
Middle Name:
Last Name:EATON
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:JAMES M
Other - Middle Name:
Other - Last Name:EATON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:M D
Mailing Address - Street 1:PO BOX 55404
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72215-5404
Mailing Address - Country:US
Mailing Address - Phone:501-664-0483
Mailing Address - Fax:501-664-0483
Practice Address - Street 1:2 TEMPLIN TRL
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5046
Practice Address - Country:US
Practice Address - Phone:501-664-0483
Practice Address - Fax:501-664-0483
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR3655207LA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR112364001Medicaid
ARC67849Medicare UPIN
AR112364001Medicaid