MEDICARE: EAGLE PHYSICIANS AND ASSOCIATES PA

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	2085U0001X	Diagnostic Ultrasound Physician

General Provider Information

NPI Number	:	1790989739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAGLE PHYSICIANS AND ASSOCIATES PA

Provider Business Mailing Address
First Line	:	324 W WENDOVER AVE STE 211
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27408-8438
Country	:	US
Telephone Number	:	336-268-3129
Fax Number	:	336-691-8042

Provider Business Practice Location Address
First Line	:	301 E WENDOVER AVE STE 200
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-1232
Country	:	US
Telephone Number	:	336-268-3395
Fax Number	:	336-272-7134

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	LESLIE HEATHER HINZE
Credential	:
Telephone Number	:	336-268-3129

Provider Enumeration Date	:	06/13/2007
Last Update Date	:	01/05/2026

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Practice Location Address:

301 E WENDOVER AVE STE 211
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1447291661 — ALBERT KENNETH BARTKO MD
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1144250820 — RUPASHREE VARADARAJAN M.D.
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1962426817 — DR. AJAY KUMAR MD
Practice Location Address:

301 E WENDOVER AVE STE 211
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27401-1232

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1922177013 — JAMES C OSBORNE MD
Practice Location Address:

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1720149578 — MRS. JENNIFER REEVES WILLARD PA-C
Practice Location Address:

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Directions to “EAGLE PHYSICIANS AND ASSOCIATES PA ” Practice Location

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