Provider Demographics
NPI:1780940320
Name:EATON, JONATHAN SHEFFIELD (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:SHEFFIELD
Last Name:EATON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1202 LOUISIANA AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-3910
Mailing Address - Country:US
Mailing Address - Phone:318-212-8546
Mailing Address - Fax:318-212-4153
Practice Address - Street 1:1202 LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-3910
Practice Address - Country:US
Practice Address - Phone:318-212-8546
Practice Address - Fax:318-212-4153
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.207978207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine