| Marc W. Eaton, Ph.d., P.c. | |
|
1227 Alice St Waycross GA 31501-4524 | |
| (912) 283-6629 | |
| (912) 283-5980 |
| Full Name | Marc W. Eaton, Ph.d., P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 1227 Alice St, Waycross, Georgia |
| Authorized Official Name and Position | Marc Wells Eaton (PRESIDENT) |
| Authorized Official Contact | 9122836629 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marc W. Eaton, Ph.d., P.c. 1227 Alice St Waycross GA 31501-4524 Ph: (912) 283-6629 | Marc W. Eaton, Ph.d., P.c. 1227 Alice St Waycross GA 31501-4524 Ph: (912) 283-6629 |
| NPI Number | 1336326289 |
|---|---|
| Provider Enumeration Date | 01/23/2008 |
| Last Update Date | 01/23/2008 |
| Medicare PECOS PAC ID | 3779670963 |
|---|---|
| Medicare Enrollment ID | O20080201000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336326289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY000673 (Georgia) | Primary |
| Provider Name | Marc W Eaton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093752313 PECOS PAC ID: 2264435163 Enrollment ID: I20060815000204 |
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