MEDICARE: DR. MARTIN PHAN EASON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LA0401X	Addiction Medicine (Anesthesiology) Physician	0101244335	VA
2	207LA0401X	Addiction Medicine (Anesthesiology) Physician	40649	TN

General Provider Information

NPI Number	:	1356699433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN PHAN EASON MD

Provider Business Mailing Address
First Line	:	2911 ESSARY DR STE 200
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-2469
Country	:	US
Telephone Number	:	865-371-8101
Fax Number	:

Provider Business Practice Location Address
First Line	:	2911 ESSARY DR STE 200
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-2469
Country	:	US
Telephone Number	:	865-371-8101
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2012
Last Update Date	:	03/20/2025

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