Eastham, R Jack

Eastham, R Jack is an individual health care provider with primary practice located at 1000 East High Street Suite A, Charlottesville VA 22902-4848. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Eastham, R Jack can be contacted via phone (434) 817-2300.

Contact Information

Primary practice address
1000 East High Street Suite A Charlottesville VA 22902-4848
Phone: (434) 817-2300
Fax: (434) 817-2306
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 0101020554 Virginia

Profile Details

NPI number 1477518389
LBN Legal business name Eastham, R Jack
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477518389 NPPES
Virginia Other 419580 SOUTHERN HEALTH
Virginia MEDICAID 6577725 SOUTHERN HEALTH
Virginia Other 014258 SOUTHERN HEALTH

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