Provider Demographics
NPI:1700175627
Name:DONALD A MCEACHERN MD PA
Entity Type:Organization
Organization Name:DONALD A MCEACHERN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:ALVIN
Authorized Official - Last Name:MCEACHERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-497-2138
Mailing Address - Street 1:1511 TAMIAMI TRL S STE 201
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-5578
Mailing Address - Country:US
Mailing Address - Phone:941-497-2138
Mailing Address - Fax:941-981-1440
Practice Address - Street 1:1511 TAMIAMI TRL S STE 201
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-5578
Practice Address - Country:US
Practice Address - Phone:941-497-2138
Practice Address - Fax:941-981-1440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME34419207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD53886Medicare UPIN