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Robert Royal Eastman

Emergency Medicine

Allopathic & Osteopathic Physicians

269 S Candy Ln, Cottonwood, AZ 86326-4158

PECOS Enrollment

This provider is enrolled in PECOS as ROBERT EASTMAN.

Based on the most recent information from CMS, provider Robert Royal Eastman is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1609877505
Provider Type
Individual
Full Name
Eastman, Robert Royal
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
8/2/2005
Last Updated
7/14/2021

Contact Information

Practice Location

269 S Candy Ln, Cottonwood, AZ 86326-4158

(928) 639-6172

(928) 639-6682

Mailing Location

1200 N Beaver St, Flagstaff, AZ 86001-3118

(928) 213-6235

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207P00000X Primary	Description Emergency Medicine Allopathic & Osteopathic Physicians	License 2021023620 Missouri
Code 207P00000X	Description Emergency Medicine Allopathic & Osteopathic Physicians	License 51402 Arizona
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License 2021023620 Missouri
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License 39761-020 Wisconsin
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License MD2015-0820 New Mexico
Code 208600000X	Description Surgery Allopathic & Osteopathic Physicians	License 39761-020 Wisconsin

Provider Identifiers

ID	Description	Issuer
ID 32433200	Description Medicaid	Issuer Unlisted Wisconsin

Robert Royal Eastman

PECOS Enrollment

Profile Details

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