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NPI Code Detail

MEDICARE: CHRISTIAN WESLEY EATON MA

MEDICARE: CHRISTIAN WESLEY EATON MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-11-8987IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144594862
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN WESLEY EATON MA
Provider Business Mailing Address
First Line : 3500 DEPAUW BLVD STE 3070
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-6135
Country : US
Telephone Number : 317-939-5377
Fax Number : 317-932-7880
Provider Business Practice Location Address
First Line : 160 PLAINFIELD VILLAGE DR STE 101
Second Line :
City : PLAINFIELD
State : IN
Zip : 46168-2782
Country : US
Telephone Number : 463-888-0118
Fax Number : 317-520-8200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2012
Last Update Date : 08/12/2020

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Directions to “ CHRISTIAN WESLEY EATON MA” Practice Location

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