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NPI Code Detail

MEDICARE: DR. EMORY LEVON EASTIN M.D.

MEDICARE: DR. EMORY LEVON EASTIN 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
1207V00000XObstetrics & Gynecology PhysicianJ4095TX
2207V00000XObstetrics & Gynecology Physician29390SC
3207V00000XObstetrics & Gynecology Physician04-50625KS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00387008GOTHERGAMEDICARE RAILROAD PTAN#
2P00708630OTHERSCRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861475402
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMORY LEVON EASTIN M.D.
Provider Business Mailing Address
First Line : PO BOX 743070
Second Line :
City : ATLANTA
State : GA
Zip : 30374-3070
Country : US
Telephone Number : 864-560-4304
Fax Number : 864-560-4413
Provider Business Practice Location Address
First Line : 4801 ALBERTA AVE
Second Line :
City : EL PASO
State : TX
Zip : 79905-2707
Country : US
Telephone Number : 915-215-5000
Fax Number : 915-215-8662
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 01/08/2026

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