Provider Demographics
NPI:1518060995
Name:EASTES, WILLIAM DAVID (DC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DAVID
Last Name:EASTES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 E 4TH
Mailing Address - Street 2:
Mailing Address - City:PRATT
Mailing Address - State:KS
Mailing Address - Zip Code:67124
Mailing Address - Country:US
Mailing Address - Phone:620-672-3638
Mailing Address - Fax:620-672-3639
Practice Address - Street 1:223 E 4TH
Practice Address - Street 2:
Practice Address - City:PRATT
Practice Address - State:KS
Practice Address - Zip Code:67124
Practice Address - Country:US
Practice Address - Phone:620-672-3638
Practice Address - Fax:620-672-3639
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2012-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0103836111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
060894Medicare ID - Type Unspecified
T44098Medicare UPIN