Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | S-B57-TA-770 | AL |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | S-B57-TA-770 | AL |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | S-B57-TA-770 | AL |
N | 152WP0200X | Pediatric Optomitrist | S-B57-TA-770 | AL |
N | 152WS0006X | Sports Vision | S-B57-TA-770 | AL |
N | 152WV0400X | Optomitrist - Vision Therapist | S-B57-TA-770 | AL |
N | 152WX0102X | Occupational Vision | S-B57-TA-770 | AL |
NPI | 1306032362 |
---|---|
Provider Name | Dr. Daniel Joseph Eagan JR. |
First Address | Auburn, AL 36830-4201 |
Second Address | Auburn, AL 36830-4201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2007 |
Last Update Date | 04/08/2011 |