Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 1536 | GA |
N | 207V00000X | Obstetrician & Gynecologist | 253182 | NY |
NPI | 1003008111 |
---|---|
Provider Name | Dr. Marie Owsley Easterlin |
First Address | Brunswick, GA 31520-2199 |
Second Address | Brunswick, GA 31520-2199 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2007 |
Last Update Date | 02/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003113870A | (05) | GA |