Provider Demographics
NPI:1205800331
Name:EASON, R STUART (MD)
Entity type:Individual
Prefix:DR
First Name:R
Middle Name:STUART
Last Name:EASON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2450 E GUADALUPE RD
Mailing Address - Street 2:STE 107
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-5116
Mailing Address - Country:US
Mailing Address - Phone:480-507-0600
Mailing Address - Fax:480-558-7162
Practice Address - Street 1:2450 E GUADALUPE RD
Practice Address - Street 2:STE 107
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-5116
Practice Address - Country:US
Practice Address - Phone:480-507-0600
Practice Address - Fax:480-558-7162
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2007-11-06
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Provider Licenses
StateLicense IDTaxonomies
AZ22403207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ168650OtherAHCCCS
AZ0066310OtherHEALTHNET
AZAZ0869340OtherBLUE CROSS BLUE SHIELD
AZC68229Medicare UPIN
AZZ63020Medicare PIN