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General NPI Number Information
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NPI Number | 1982097911
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Entity Type | Organization
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Legal Business Name | DOCTOR JAMES E. EASH, D.D.S., P.C.
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Dates
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Enumeration Date | 03/16/2015
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Last Update Date | 03/16/2015
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Provider Practice Location Address
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Address Line | 911 AIGNER DRIVE
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City | BOONVILLE
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State | IN
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Zip | 47601
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Country | US
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Telephone | 812-897-1410
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Fax | 812-897-1464
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Provider Business Mailing Address
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Address Line | 911 AIGNER DRIVE
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City | BOONVILLE
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State | IN
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Zip | 47601
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Country | US
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Telephone | 812-897-1410
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Fax | 812-897-1464
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | JAMES EDWIN EASH
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Credential | M.D.
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Telephone | 812-897-1410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 12008687A
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License Number State | IN
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