Individual
DR. JEFFREY ARNOLD EASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4619 COVINGTON RD., FORT WAYNE, IN 46804
(419) 605-8668
(419) 232-4498
Mailing address
4619 COVINGTON RD., FORT WAYNE, IN 46804
(419) 605-8668
(419) 232-4498
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01073504A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0784441
—
OH
Enumeration date
01/27/2006
Last updated
01/17/2020
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