Provider Demographics
NPI:1003008111
Name:EASTERLIN, MARIE OWSLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:OWSLEY
Last Name:EASTERLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:418 EH CT
Mailing Address - Street 2:UNIT 4B
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-2199
Mailing Address - Country:US
Mailing Address - Phone:912-267-0884
Mailing Address - Fax:913-267-9396
Practice Address - Street 1:418 EH CT
Practice Address - Street 2:UNIT 4B
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-2199
Practice Address - Country:US
Practice Address - Phone:912-267-0884
Practice Address - Fax:913-267-9396
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1536207V00000X
NY253182207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003113870AMedicaid