Provider Demographics
NPI:1609866938
Name:EANES, JOHN II (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:EANES
Suffix:II
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1001 JOHNSON FY RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1605
Mailing Address - Country:US
Mailing Address - Phone:404-785-4826
Mailing Address - Fax:404-785-4820
Practice Address - Street 1:1577 NORTHEAST EXPY NE
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30329-2401
Practice Address - Country:US
Practice Address - Phone:404-785-0976
Practice Address - Fax:404-785-5845
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA56433208000000X
VA0101057093208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics