Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | OS14631 | FL |
NPI | 1003862244 |
---|---|
Provider Name | Dr. Charles Curry Eaves JR. |
First Address | Panama City Beach, FL 32408-7141 |
Second Address | Marianna, FL 32446-1917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 08/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E61433 | (02) |