Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 0101255773 | VA |
Y | 2080P0204X | Pediatric Emergency Doctor | 0101255773 | VA |
NPI | 1255620753 |
---|---|
Provider Name | Margaret Kelly Eason |
First Address | Norfolk, VA 23507-1910 |
Second Address | Norfolk, VA 23507-1910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2011 |
Last Update Date | 11/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VVH845A | MEDICARE PECOS (01) | VA |