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NPI Code Detail

MEDICARE: DONALD EASON M.D.

MEDICARE: DONALD EASON M.D.
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
1208000000XPediatrics PhysicianME0059921FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538163159
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD EASON M.D.
Provider Business Mailing Address
First Line : 1119 INTERLOCHEN BLVD
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33884-3707
Country : US
Telephone Number : 863-289-6060
Fax Number :
Provider Business Practice Location Address
First Line : 1119 INTERLOCHEN BLVD
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33884-3707
Country : US
Telephone Number : 863-289-6060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 03/19/2020

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