MEDICARE: DR. ROYAL J EATON M.D.

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
1	207RP1001X	Pulmonary Disease Physician	MO30472	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CE7661	OTHER	MO	RR MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1780675264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROYAL J EATON M.D.

Provider Business Mailing Address
First Line	:	11133 DUNN RD
Second Line	:	SUITE 2335
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-6119
Country	:	US
Telephone Number	:	314-653-5007
Fax Number	:

Provider Business Practice Location Address
First Line	:	11133 DUNN RD
Second Line	:	SUITE 2335
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-6119
Country	:	US
Telephone Number	:	314-653-5007
Fax Number	:	314-653-4149

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	05/08/2012

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Directions to “ DR. ROYAL J EATON M.D.” Practice Location

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