Provider Demographics
NPI:1659507622
Name:EAGON, STEVEN (MS-CCC-A)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:EAGON
Suffix:
Gender:M
Credentials:MS-CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WESTWOOD PL STE 300
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-1033
Mailing Address - Country:US
Mailing Address - Phone:800-432-7669
Mailing Address - Fax:405-721-1555
Practice Address - Street 1:100 WESTWOOD PL STE 300
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-1033
Practice Address - Country:US
Practice Address - Phone:800-432-7669
Practice Address - Fax:405-721-1555
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNA0000001208231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist