Name: | Dr. Robert W. Eaton, P.C. |
Jurisdiction: | Alabama |
Legal type: | Domestic Professional Corporation |
Status: | Exists |
Date of registration: | 31 Jul 2003 (21 years ago) |
Entity Number: | 000-230-278 |
Register Number: | 000230278 |
County: | Tuscaloosa |
Place of Formation: | Tuscaloosa County |
Principal Address: | TUSCALOOSA, AL |
Registered Office Street Address: | 1649 MCFARLAND BLVD N STE 201TUSCALOOSA, AL 35406 |
Registered Office Street Address ZIP Code: | 35406 |
Authorized Capital: | $1,000 |
Activities
MEDICINE PRACTICE
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1265477541 | 2006-06-19 | 2009-12-15 | 5004 HIGHWAY 69 N, NORTHPORT, AL, 354732039, US | 5004 HIGHWAY 69 N, NORTHPORT, AL, 354732039, US | |||||||||||||||||||||
|
Phone | +1 205-339-2499 |
Fax | 2053396422 |
Authorized person
Name | DR. ROBERT W EATON |
Role | PHYSICIAN |
Phone | 2053392499 |
Taxonomy
Taxonomy Code | 305R00000X - Preferred Provider Organization |
Is Primary | Yes |
Other Provider Identifiers
Issuer | BLUE CROSS BLUE SHIELD |
Number | 51515058 |
State | AL |
Name | Role |
---|---|
EATON, ROBERT W | Agent |
Name | Role |
---|---|
EATON, ROBERT W | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State