Provider Demographics
NPI:1356699433
Name:EASON, MARTIN PHAN (MD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:PHAN
Last Name:EASON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 ESSARY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-2469
Mailing Address - Country:US
Mailing Address - Phone:865-371-8101
Mailing Address - Fax:
Practice Address - Street 1:2911 ESSARY DR STE 200
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-2469
Practice Address - Country:US
Practice Address - Phone:865-371-8101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101244335207LA0401X
TN40649207LA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine