Individual provider Active NPI

Mark Joseph Eanes, M.D.

  • Ophthalmology Physician
  • Valdosta, GA
National Provider Identifier
1205947496
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
25970 Issued in GA
Practice address
206 S Patterson St
Valdosta, GA 31601-5668
Phone
(229) 333-5290
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 025970 GA
Ophthalmology Physician 207W00000X 25970 GA Primary

Addresses

Primary practice location

206 S Patterson St
Valdosta, GA 31601-5668

Mailing address

PO Box 5147
Valdosta, GA 31603-5147
Phone (229) 333-5290

Other identifiers 1

IdentifierTypeStateIssuer
000330316DMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120229000766 GA Practitioner - Ophthalmology 3779697776 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25970GAMDOphthalmology Physician
025970GAMDPublic Health or Welfare Agency

Practice roles

OrganizationSpecialtyStatusNew patients
South Health District Public Health Or Welfare CurrentSince Aug 1, 2023 Accepting new patients
South Health District Public Health Or Welfare CurrentSince Aug 1, 2023 Accepting new patients

Locations

206 S Patterson St
Valdosta, GA 31601
Phone (229) 245-6565

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1205947496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5147",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316035147",
            "telephone_number": "229-333-5290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316015668",
            "telephone_number": "229-333-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EANES",
        "first_name": "MARK",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "GA",
            "license": "025970",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "25970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000330316D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.