MEDICARE: DR. KYLE EATON O.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	152W00000X	Optometrist	2025	NC

General Provider Information

NPI Number	:	1881755866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KYLE EATON O.D.

Provider Business Mailing Address
First Line	:	PO BOX 787
Second Line	:
City	:	BURGAW
State	:	NC
Zip	:	28425-0787
Country	:	US
Telephone Number	:	910-259-5661
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 EAST SATCHWELL ST
Second Line	:
City	:	BURGAW
State	:	NC
Zip	:	28425-5064
Country	:	US
Telephone Number	:	910-259-5661
Fax Number	:

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	09/08/2009

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Directions to “ DR. KYLE EATON O.D.” Practice Location

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