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Individual

MARVIN L. EASON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1000 HIGHWAY 28, JASPER, TN 37347-3638
(423) 837-9500
(865) 539-8008
Mailing address
PO BOX 634706, CINCINNATI, OH 45263-0001

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD12900
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3045821
BLUE CROSS
TN
01
3070472
BCBS OF TENNESSEE
TN
05
3809907
TN
05
3809908
TN
01
P00285998
RAILROAD MEDICARE
TN
Enumeration date
06/21/2006
Last updated
11/19/2007
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