Provider Demographics
NPI:1154346294
Name:EATON, L DANIEL
Entity type:Individual
Prefix:
First Name:L DANIEL
Middle Name:
Last Name:EATON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 N VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3650
Mailing Address - Country:US
Mailing Address - Phone:501-265-0100
Mailing Address - Fax:501-265-0102
Practice Address - Street 1:220 N VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3650
Practice Address - Country:US
Practice Address - Phone:501-265-0100
Practice Address - Fax:501-265-0102
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR84-189-08174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR35217806300OtherDME/QUALCHOICE
NY02593066Medicaid
AR140207716Medicaid
AR49597OtherDME/BCBS
MS325862803Medicare NSC
AR49597OtherDME/BCBS