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General NPI Number Information
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NPI Number | 1316921125
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Entity Type | Individual
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Provider Name | ERNEST BERNARD EASON MD
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Gender | Male
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1522 VAUGHN RD
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City | BURLINGTON
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State | NC
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Zip | 27217-2853
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Country | US
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Telephone | 336-226-1658
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Fax | 336-228-9363
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Provider Business Mailing Address
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Address Line | PO BOX 3481 1522 VAUGHN ROAD
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City | BURLINGTON
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State | NC
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Zip | 27215-0481
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Country | US
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Telephone | 336-226-1658
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Fax | 336-228-9363
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 26815
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35046574
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License Number State | OH
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