Provider Demographics
NPI:1083607824
Name:EASTERLING, WILLIAM ROSS (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ROSS
Last Name:EASTERLING
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 W ASH ST
Mailing Address - Street 2:STE 7
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-3665
Mailing Address - Country:US
Mailing Address - Phone:919-735-0613
Mailing Address - Fax:919-735-0183
Practice Address - Street 1:201 W ASH ST
Practice Address - Street 2:SUITE 7
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-3665
Practice Address - Country:US
Practice Address - Phone:919-735-0613
Practice Address - Fax:919-735-0183
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0887152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909251Medicaid
T64777Medicare UPIN
NC0898980001Medicare NSC
NC8909251Medicaid