Provider Demographics
NPI:1700319076
Name:EASEY, ERIC ELTON (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:ELTON
Last Name:EASEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 CUSTER ST
Mailing Address - Street 2:
Mailing Address - City:NESS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67560-1654
Mailing Address - Country:US
Mailing Address - Phone:785-798-2233
Mailing Address - Fax:
Practice Address - Street 1:316 CUSTER ST
Practice Address - Street 2:
Practice Address - City:NESS CITY
Practice Address - State:KS
Practice Address - Zip Code:67560-1654
Practice Address - Country:US
Practice Address - Phone:785-798-2233
Practice Address - Fax:785-798-9743
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC40868207Q00000X
KS04-43488207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine