Healthcare Provider Details

I. General information

NPI: 1932189933
Provider Name (Legal Business Name): ANITA FAY EASON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANITA FAY EASON-JONES MD

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 01/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 19TH ST S
BIRMINGHAM AL
35233-1927
US

IV. Provider business mailing address

700 19TH ST S
BIRMINGHAM AL
35233-1927
US

V. Phone/Fax

Practice location:
  • Phone: 256-535-3100
  • Fax: 256-539-0689
Mailing address:
  • Phone: 256-535-3100
  • Fax: 256-539-0689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number17724
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: