Provider Demographics
NPI:1932352622
Name:EAKINS, CHAUNCY L SR (MD)
Entity type:Individual
Prefix:DR
First Name:CHAUNCY
Middle Name:L
Last Name:EAKINS
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 CATALPA RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-7018
Mailing Address - Country:US
Mailing Address - Phone:937-369-4933
Mailing Address - Fax:
Practice Address - Street 1:1305 CATALPA RIDGE DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-7018
Practice Address - Country:US
Practice Address - Phone:937-369-4933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301104658208100000X
OH35.127079CRT2081P2900X
OH35. 127079208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine