R JACK EASTHAM (NPI# 1477518389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477518389 |
| Entity Type | Individual |
| Full Name | R JACK EASTHAM |
| Credential | MD |
| Practice Address |
1000 East High Street Suite A Charlottesville VA 22902-4848 |
| Practice Telephone | 4348172300 |
| Practice Fax Number | 4348172306 |
| Mailing Telephone | 4348172300 |
| Mailing Fax Number | 4348172306 |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 0101020554 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 6577725 | 05 | |
| VA | ANTHEM BC BS | 014258 | 01 |
| VA | SOUTHERN HEALTH | 419580 | 01 |
| Street Address |
1000 EAST HIGH STREET SUITE A |
| City | CHARLOTTESVILLE |
| State | VA |
| Zip Code | 22902-4848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548393234 | Christopher Mark Scott | Dermatology | 1000 East High Street, Suite B, Charlottesville, VA 22902-4848 | 2007-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699263608 | Jeraline Rachele Evans | Health Educator | 151 Mcintire Park Dr. (piedmont Family Ymca), Charlottesville, VA 22902 | 2018-04-25 |
| 1457853905 | Elizabeth Blaker Tyson Walter | Speech-Language Pathologist | 401 Mcintire Rd. Room 323, Charlottesville, VA 22902 | 2018-03-01 |
| 1376056317 | Erin E Horn | Psychologist | 302 Park St Ste 204, Charlottesville, VA 22902 | 2017-11-13 |
| 1023429982 | Barrie Gleason Carveth | Nurse Practitioner | 435 Merchant Walk Sq, Charlottesville, VA 22902 | 2014-05-14 |
| 1285054825 | Alfred N. Yarbrough | Dentist | 1101 East Jefferson Street, Suite 7, Charlottesville, VA 22902 | 2014-04-22 |
| 1801227400 | Fox & Brantley Internal Medicine, A Division of Anchor Healthcare, Plc | Internal Medicine | 908 E Jeffeson St, Suite G1, Charlottesville, VA 22902 | 2013-12-06 |
| 1245557982 | Wendy Price Summer | Counselor | 509 Park Street, Charlottesville, VA 22902 | 2010-04-20 |
| 1659520914 | Christie Marie Savage | Acupuncturist | 108 5th St Se, Suite 207, Charlottesville, VA 22902 | 2008-09-11 |
| 1376733063 | Alison C. Derbes | Radiology | 107 S 1st St, Apartment 401, Charlottesville, VA 22902 | 2007-07-28 |
| 1275732901 | Cali Belknap Gaston | Acupuncturist | 420 Third Street, Ne, Charlottesville, VA 22902 | 2007-07-12 |
| Find all providers in zip 22902 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508151887 | Jose Luis Mattos | Otolaryngology | 415 Ray C. Hunt Dr Ste 2200, Charlottesville, VA 22903-0001 | 2011-06-14 |
| 1013087295 | Paul A. Levine | Otolaryngology | 415 Ray C. Hunt Drive, Suite 2200, Uva Ent Clinic @ Fontaine, Charlottesville, VA 22903 | 2006-11-08 |
| 1972672509 | Daniel A. Landes | Otolaryngology | 652 Peter Jefferson Pkwy Ste 140, Charlottesville, VA 22911-8851 | 2006-11-07 |
| 1073564993 | Mark James Jameson | Otolaryngology | 415 Ray C Hunt Dr Ste 2200, Charlottesville, VA 22903-2980 | 2006-05-15 |
| 1679564777 | Spencer Cranston Payne | Otolaryngology | 415 Ray C. Hunt Drive, Suite 1200, Charlottesville, VA 22903-0001 | 2005-10-31 |
| 1982181905 | Martin Hanson | Otolaryngology | 415 Ray C Hunt Dr Ste 2200, Charlottesville, VA 22903-2980 | 2018-07-23 |
| 1487073516 | Jonathan Constantine Garneau | Otolaryngology | 415 Ray C Hunt Dr Ste 2200, Charlottesville, VA 22903-2980 | 2014-04-16 |
| 1699109884 | Jeffrey Yu | Otolaryngology | 415 Ray C Hunt Dr, Suite 2200, Charlottesville, VA 22908-0001 | 2013-08-25 |
| 1972946796 | Patrick O Mcgarey Jr. | Otolaryngology | 415 Ray C Hunt Dr Ste 2200, Charlottesville, VA 22903-2980 | 2013-04-11 |
| 1730404435 | William T Brand | Otolaryngology | 1204 W Main St Fl 6, Charlottesville, VA 22908 | 2010-04-06 |
| Find all providers in CHARLOTTESVILLE | ||||
| City | CHARLOTTESVILLE |
| Zip Code | 22902 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.