Easley, Jeffrey Arnold
Easley, Jeffrey Arnold is an sole proprietor health care provider with primary practice located at 4619 Covington Rd. , Fort Wayne IN 46804. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Easley, Jeffrey Arnold can be contacted via phone (419) 605-8668.Contact Information
Primary practice address
4619 Covington Rd.
Fort Wayne IN 46804
Phone: (419) 605-8668
Fax: (419) 232-4498
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01073504A | Indiana |
Profile Details
| NPI number | 1790756914 |
|---|---|
| LBN Legal business name | Easley, Jeffrey Arnold |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 27th, 2006 |
| Last updated | Jan 17th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790756914 | NPPES |
| Ohio | MEDICAID | 0784441 |
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