Eades, Jack R
Eades, Jack R is an individual health care provider with primary practice located at 6501 Peake Rd Ste 1000 , Macon GA 31210-8052. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Eades, Jack R can be contacted via phone (478) 607-2514.Contact Information
Primary practice address
6501 Peake Rd Ste 1000
Macon GA 31210-8052
Phone: (478) 607-2514
Fax: (478) 607-2513
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | 20053 | South Carolina |
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | 043360 | Georgia |
Profile Details
| NPI number | 1992890727 |
|---|---|
| LBN Legal business name | Eades, Jack R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 4th, 2006 |
| Last updated | May 17th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992890727 | NPPES |
| Georgia | MEDICAID | 00751264D | |
| Georgia | MEDICAID | 00751264F | |
| Georgia | MEDICAID | G43360 | |
| Georgia | MEDICAID | 00751264E |
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