Individual
KENT WILLIAM EASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2727 HEARNE AVE, SUITE 300, SHREVEPORT, LA 71103-3931
(318) 798-9400
(318) 798-3894
Mailing address
PO BOX 51008, SHREVEPORT, LA 71135-1008
(318) 798-9400
(318) 798-3894
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200005
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1527572
—
LA
Enumeration date
05/21/2007
Last updated
05/27/2015
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