Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | MD07000 | RI |
NPI | 1043254329 |
---|---|
Provider Name | J Donald Easton |
First Address | Providence, RI 02903-4141 |
Second Address | Providence, RI 02905-3236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7002089 | (05) | RI |
D10625 | (02) | RI |