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Individual

ALISA KATHERINE EANES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1633 SUGAR HILL RD, MARION, NC 28752-5239
(828) 659-3621
Mailing address
1633 SUGAR HILL RD, MARION, NC 28752-5239
(828) 659-3621

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2017-01136
NC
207VG0400X
Gynecology Physician
2017-01136
NC
207VX0000X
Obstetrics Physician
2017-01136
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2017-01136
MEDICAL LICENSE
NC
01
NN735A
MAHEC MEDICARE PTAN
NC
Enumeration date
04/17/2015
Last updated
06/25/2020
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