Provider Demographics
NPI:1295854800
Name:EASON, HERMAN L JR (PA)
Entity Type:Individual
Prefix:MR
First Name:HERMAN
Middle Name:L
Last Name:EASON
Suffix:JR
Gender:M
Credentials:PA
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Mailing Address - Street 1:1509 VERNON RD
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3525
Mailing Address - Country:US
Mailing Address - Phone:215-327-1127
Mailing Address - Fax:
Practice Address - Street 1:5800 RIDGE AVE
Practice Address - Street 2:ROXBOROUGH HOSPITAL - SUITE 234
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-1737
Practice Address - Country:US
Practice Address - Phone:215-487-4540
Practice Address - Fax:215-487-4544
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PAMA-003085-L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical