| Easterly Family Medicine | |
|
104 Parliament Drive Maryville TN 37804-6209 | |
| (865) 233-7425 | |
| (865) 981-4239 |
| Full Name | Easterly Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 104 Parliament Drive, Maryville, Tennessee |
| Authorized Official Name and Position | Jeffrey Easterly (OWNER) |
| Authorized Official Contact | 8652337425 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Easterly Family Medicine 104 Parliament Drive Maryville TN 37804-6209 Ph: (865) 233-7425 | Easterly Family Medicine 104 Parliament Drive Maryville TN 37804-6209 Ph: (865) 233-7425 |
| NPI Number | 1649538802 |
|---|---|
| Provider Enumeration Date | 04/25/2012 |
| Last Update Date | 04/25/2012 |
| Medicare PECOS PAC ID | 1759547813 |
|---|---|
| Medicare Enrollment ID | O20120718000560 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649538802 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD0000034802 (Tennessee) | Primary |
| Provider Name | Jeffery L Easterly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134165178 PECOS PAC ID: 2365486321 Enrollment ID: I20050610000775 |
| Provider Name | Dana E Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972212090 PECOS PAC ID: 8022488592 Enrollment ID: I20221227000483 |
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