Provider Demographics
NPI:1871533901
Name:EAKINS, JOEY WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:JOEY
Middle Name:WILLIAM
Last Name:EAKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 602484
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2484
Mailing Address - Country:US
Mailing Address - Phone:910-343-9991
Mailing Address - Fax:910-343-8448
Practice Address - Street 1:1960 S 16TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6676
Practice Address - Country:US
Practice Address - Phone:910-343-9991
Practice Address - Fax:910-343-8448
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16857207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8929760Medicaid
NC1871533901Medicaid
C85191Medicare UPIN
NC1022110001Medicare NSC
NCNCC267AMedicare PIN
NC1871533901Medicaid
NC110124300Medicare UPIN
NC201511AMedicare PIN