Eastham, R Jack
Eastham, R Jack is an individual health care provider with primary practice located at 1000 East High Street Suite A, Charlottesville VA 22902-4848. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Eastham, R Jack can be contacted via phone (434) 817-2300.Contact Information
Primary practice address
1000 East High Street Suite A
Charlottesville VA 22902-4848
Phone: (434) 817-2300
Fax: (434) 817-2306
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 0101020554 | Virginia |
Profile Details
| NPI number | 1477518389 |
|---|---|
| LBN Legal business name | Eastham, R Jack |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477518389 | NPPES |
| Virginia | Other | 419580 | SOUTHERN HEALTH |
| Virginia | MEDICAID | 6577725 | SOUTHERN HEALTH |
| Virginia | Other | 014258 | SOUTHERN HEALTH |
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