Eakin, Kenneth Max
Eakin, Kenneth Max is an individual health care provider with primary practice located at 3 Junction Dr W , Glen Carbon IL 62034-2916. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Eakin, Kenneth Max can be contacted via phone (618) 288-5088.Contact Information
Primary practice address
3 Junction Dr W
Glen Carbon IL 62034-2916
Phone: (618) 288-5088
Fax: (618) 288-9153
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036066196 | Illinois |
Profile Details
| NPI number | 1174529556 |
|---|---|
| LBN Legal business name | Eakin, Kenneth Max |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2005 |
| Last updated | Apr 30th, 2008 - about 16 years ago |
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 | 1174529556 | NPPES |
| Illinois | Other | 080021116 | RR MEDICARE |
| Illinois | Other | 0107335 | RR MEDICARE |
| Illinois | Other | 371205888 | RR MEDICARE |
| Illinois | Other | 118802 | RR MEDICARE |
| Illinois | Other | N4882 | RR MEDICARE |
| Illinois | MEDICAID | 036066196 | RR MEDICARE |
| Illinois | Other | 4622029 | RR MEDICARE |
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