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NPI Code Detail

MEDICARE: BENJAMIN EAKES NP

MEDICARE: BENJAMIN EAKES NP
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
1363L00000XNurse PractitionerAPRN11016770TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
117844OTHERTNLICENSE

General Provider Information

NPI Number : 1467887075
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN EAKES NP
Provider Business Mailing Address
First Line : 403 E 11TH ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32401-3409
Country : US
Telephone Number : 602-778-3600
Fax Number : 602-778-3602
Provider Business Practice Location Address
First Line : 2235 E 15TH ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-6023
Country : US
Telephone Number : 850-747-5272
Fax Number : 850-747-5274
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2013
Last Update Date : 03/17/2026

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