Provider Demographics
NPI:1295350775
Name:CYNTHIA J EASTER MD LLC
Entity type:Organization
Organization Name:CYNTHIA J EASTER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:EASTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-924-0979
Mailing Address - Street 1:1536 MINT MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37803-2542
Mailing Address - Country:US
Mailing Address - Phone:865-924-0979
Mailing Address - Fax:
Practice Address - Street 1:641 MORGANTON SQUARE DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-4763
Practice Address - Country:US
Practice Address - Phone:865-724-1590
Practice Address - Fax:865-724-1591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-10
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty