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Dr. Robert W. Eaton, P.C.

Details

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

National Provider Identifier

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

Contacts

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

Agent

Name Role
EATON, ROBERT W Agent

Incorporator

Name Role
EATON, ROBERT W Incorporator

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State