DR. ROBERT FANNING EAVES JR. (NPI# 1790027688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790027688 |
| Entity Type | Individual |
| Full Name | DR. ROBERT FANNING EAVES JR. |
| Credential | M.D. |
| Practice Address |
5394 Leatherstocking Lane Stone Mountain GA 30087 |
| Mailing Address |
5394 Leather Stocking Lane Stone Mountain GA 30087 |
| Practice Telephone | 7709383223 |
| Practice Fax Number | 7709383223 |
| Mailing Telephone | 7709383223 |
| Mailing Fax Number | 7709383223 |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2013-03-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 5843 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
5394 LEATHERSTOCKING LANE |
| City | STONE MOUNTAIN |
| State | GA |
| Zip Code | 30087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477176394 | Optimal Choice Telehealth | General Practice | 1227 Rockbidge Rd Sw, Ste 208-354, Stone Mountain, GA 30087 | 2020-05-27 |
| 1245882943 | Lynell Williams | Counselor | 505 Lilburn-stone Mountain Road, Suite 235, Stone Mountain, GA 30087 | 2019-07-12 |
| 1003302688 | Mark Andrew Stevens | Physical Therapist | 1227 Rockbridge Rd Ste 402, Stone Mountain, GA 30087 | 2018-07-06 |
| 1154816825 | Tuan Minh Khong | Physician Assistant | 6301 Southland Rdg, Stone Mountain, GA 30087 | 2018-06-26 |
| 1215429881 | Stephanie Martin | Nurse Practitioner | 2720 S Rockbridge Rd, Stone Mountain, GA 30087 | 2018-05-30 |
| 1578979381 | Edmund Thomas Jr. | Dentist | 2536 Rockbridge Rd Ste 103, Stone Mountain, GA 30087 | 2014-07-02 |
| 1609128917 | Mary Marlene Muse | Lactation Consultant, Non-RN | 510 Navarre Drive, Stone Mountain, GA 30087 | 2012-10-10 |
| 1457680704 | Cleo Evans | Counselor | 5638 Manassas Run, Stone Mountain, GA 30087 | 2009-12-16 |
| 1932348521 | Lawrence Randy Sheber | Dentist | 5500-a Lilburn Stone Mountain Road, Stone Mountain, GA 30087 | 2009-02-05 |
| 1730348210 | Childrens Dentistry of Lithonia LLC | Clinic/Center | 374 C North Deshon Road, Stone Mountain, GA 30087 | 2008-06-09 |
| Find all providers in zip 30087 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477176394 | Optimal Choice Telehealth | General Practice | 1227 Rockbidge Rd Sw, Ste 208-354, Stone Mountain, GA 30087 | 2020-05-27 |
| 1679785919 | William Walter Noyd | General Practice | 1755 E Park Place Blvd, Stone Mountain, GA 30087-3459 | 2007-05-07 |
| 1497955678 | Mountain Park Primary Care Center | General Practice | 1755 E Park Place Blvd, Stone Mountain, GA 30087-3459 | 2007-07-24 |
| 1154399210 | Hope Medical Group Inc | General Practice | 5300 Memorial Dr, Suite 112, Stone Mountain, GA 30083-3148 | 2006-03-14 |
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| 1285265546 | Idea Body Institute Atlanta Asc | General Practice | 371 E Paces Ferry Rd Ne Ste 450, Atlanta, GA 30305-3292 | 2020-01-27 |
| 1730729849 | Summit Health Primary and Urgent Care LLC | General Practice | 120 Handley Rd Bldg 400 Ste #410, Tyrone, GA 30290-3029 | 2020-01-07 |
| 1770121030 | New Life Medical Centers Georgia LLC | General Practice | 3550 Lenox Rd Ne Ste 2100, Atlanta, GA 30326-1810 | 2019-12-18 |
| 1659919066 | Ivydale Wellness Center | General Practice | 361 Resource Pkwy, Winder, GA 30680-8364 | 2019-12-16 |
| Find all providers with the same taxonomy | ||||
| City | STONE MOUNTAIN |
| Zip Code | 30087 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.