Eason, Jesse Blair

Eason, Jesse Blair is an individual health care provider with primary practice located at 2501 N Patterson St , Valdosta GA 31602-1735. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Eason, Jesse Blair can be contacted via phone (229) 333-1110.

Contact Information

Primary practice address
2501 N Patterson St Valdosta GA 31602-1735
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 6090 Georgia

Profile Details

NPI number 1659666063
LBN Legal business name Eason, Jesse Blair
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2011
Last updated Jan 10th, 2018 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659666063 NPPES
Georgia MEDICAID 003111610A

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