Individual
JEFFERY EASTERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
129 MONTGOMERY LN, MARYVILLE, TN 37803-5649
(865) 681-1224
Mailing address
129 MONTGOMERY LN, MARYVILLE, TN 37803-5649
(865) 681-1224
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34802
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3866200
—
TN
01
—
P00238548
RR MEDICARE PIN
TN
Enumeration date
06/20/2006
Last updated
03/24/2009
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