Provider Demographics
NPI:1144266859
Name:EATON, JAMES CRAIG (DO)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CRAIG
Last Name:EATON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:7600 S. HWY 69A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:OK
Mailing Address - Zip Code:74354-1016
Mailing Address - Country:US
Mailing Address - Phone:918-542-1655
Mailing Address - Fax:918-745-3601
Practice Address - Street 1:7600 S. HWY 69A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-1016
Practice Address - Country:US
Practice Address - Phone:918-542-1655
Practice Address - Fax:918-745-3601
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2022-02-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS0519915207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO12436OtherANTHEM
010055413OtherRR MEDICARE
KS100229540BMedicaid
KS040361OtherBCBS OF KANSAS