Individual
DOUGLAS A EASTHAM
Active
Individual
DOUGLAS A EASTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
4038
TN
363AM0700X
Medical Physician Assistant
085003810
IL
363AM0700X
Medical Physician Assistant
4038
TN
363AS0400X
Surgical Physician Assistant
085003810
IL
363AS0400X
Surgical Physician Assistant
Primary
4038
TN
Other
Enumeration date
08/06/2010
Last updated
02/18/2025
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