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Individual

CARL DAVID EASTEP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1901 E 32ND ST STE 4, JOPLIN, MO 64804-3071
(417) 781-0250
(417) 781-2581
Mailing address
1912 E LATANA DR, OZARK, MO 65721-8274
(870) 577-4991

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2019026919
MO

Other

Enumeration date
08/13/2019
Last updated
12/12/2019
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