DR. MARVIN EUGENE EASTLUND (NPI# 1619006772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619006772 |
| Entity Type | Individual |
| Full Name | DR. MARVIN EUGENE EASTLUND |
| Credential | M.D. |
| Practice Address |
5204 Tatum Ct Fort Wayne IN 46835-4633 |
| Practice Telephone | 2604869432 |
| Mailing Telephone | 2604869432 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
01022999A | IN | Allopathic & Osteopathic Physicians |
| Street Address |
5204 TATUM CT |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46835-4633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760993810 | Longe Enterprises Corp | Eyewear Supplier (Equipment, not the service) | 5711 Ymca Park Dr East, Fort Wayne, IN 46835 | 2017-10-17 |
| 1801144464 | Tracey Gordon | Physical Therapy Assistant | 2827 Northgate Boulevard, Fort Wayne, IN 46835 | 2012-08-29 |
| 1316179682 | Janet L Daniel | Counselor | 310 E Dupont Road, Suite 2, Fort Wayne, IN 46835 | 2009-08-20 |
| 1083868863 | Nicholas Joseph Sullivan | Chiropractor | 8320 Chapel Bend Drive, Fort Wayne, IN 46835 | 2008-11-06 |
| 1497922090 | Michelle A Bailey | Registered Nurse | 6108 Maplecrest Road, Fort Wayne, IN 46835 | 2008-05-13 |
| 1073789954 | Charles Arthur Bolinger | Technician, Other | 4546 Maplecrest Rd, Ft Wayne, IN 46835 | 2008-05-01 |
| 1851469878 | Richard J Klaehn | Optometrist | 4536 Maplecrest Road, Ft. Wayne, IN 46835 | 2006-11-30 |
| 1639272339 | Hook Superx LLC | Durable Medical Equipment & Medical Supplies | 6220 St Joseph Center Rd, Fort Wayne, IN 46835 | 2006-09-07 |
| 1275649014 | Adrienne Meyer | Pharmacist | 7909 Brixham Place, Fort Wayne, IN 46835 | 2006-08-22 |
| 1750378147 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 4430 Elsdale Dr, Fort Wayne, IN 46835 | 2005-09-30 |
| Find all providers in zip 46835 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407196611 | Landon Harrison | Obstetrics & Gynecology | 11123 Parkview Plaza Dr Ste 101, Fort Wayne, IN 46845-1707 | 2013-02-25 |
| 1346584638 | Dr. Lora Overton PC | Obstetrics & Gynecology | 3217 Lake Ave, Fort Wayne, IN 46805-5427 | 2012-11-27 |
| 1487802393 | Ulrich Klopfer | Obstetrics & Gynecology | 2210 Inwood Dr, Fort Wayne, IN 46815-7117 | 2008-09-04 |
| 1689861130 | Gynecology Center, Inc | Obstetrics & Gynecology | 7920 W Jefferson Blvd, Suite 260, Fort Wayne, IN 46804-4168 | 2007-09-28 |
| 1083748966 | Scott Thomas Goodrich | Obstetrics & Gynecology | 11050 Parkview Circle Dr, Fort Wayne, IN 46845 | 2007-03-15 |
| 1356357628 | Laurette C Robey | Obstetrics & Gynecology | 10343 Dawsons Creek Blvd, #6c, Fort Wayne, IN 46825-1906 | 2006-07-31 |
| 1992711105 | Laurette C. Robey, Md PC | Obstetrics & Gynecology | 10343 Dawsons Creek Blvd, #6c, Fort Wayne, IN 46825-1906 | 2006-07-31 |
| 1255376034 | Catherine S. Chung | Obstetrics & Gynecology | 11123 Parkview Plaza Dr, Fort Wayne, IN 46845-1707 | 2006-06-17 |
| 1891785200 | Marianne Watkins | Obstetrics & Gynecology | 2518 E Dupont Rd, Fort Wayne, IN 46825-1675 | 2005-10-26 |
| 1558351239 | Stephen E Coats | Obstetrics & Gynecology | 7988 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2005-10-25 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46835 |
Please comment or provide details below to improve the information on DR. MARVIN EUGENE EASTLUND.
| 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.