Individual
DR. WESLEY V EASTRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1233 RADCLIFFE AVE, KINGSPORT, TN 37664-2027
(423) 502-8656
Mailing address
1233 RADCLIFFE AVE, KINGSPORT, TN 37664-2027
(423) 502-8656
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101037010
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005609879
—
VA
01
—
037070
ANTHEM BLUE CROSS
VA
01
—
037073
ANTHEM BLUE CROSS
VA
01
—
107277
BLUE CROSS OF TENNESSEE
TN
01
—
2622550
CIGNA
—
01
—
274021
BLACK LUNG
—
05
—
4046651
—
TN
05
—
4401019
—
TN
01
—
4581788
AETNA
—
01
—
621584391
TRICARE
—
01
—
62158439108
UNITED HEALTHCARE
—
Enumeration date
04/05/2006
Last updated
09/21/2023
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