Easley, Kevin O

Easley, Kevin O is an individual health care provider with primary practice located at 12855 North Forty Dr Suite 200, St Louis MO 63141. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecologic Oncology, which is considered as his primary health care specialty. Easley, Kevin O can be contacted via phone (314) 628-1210.

Contact Information

Primary practice address
12855 North Forty Dr Suite 200 St Louis MO 63141
Phone: (314) 628-1210
Fax: (314) 628-1220
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecologic Oncology 207VX0201X 105787 Missouri

Profile Details

NPI number 1154385417
LBN Legal business name Easley, Kevin O
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2006
Last updated Jul 2nd, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154385417 NPPES
Other 431787580 GREAT WEST
Other 332932 GREAT WEST
Other 431787580 GREAT WEST
Other 54920 GREAT WEST
Other C83613 GREAT WEST
Other 3605461 GREAT WEST
Other 431787580 GREAT WEST
Other 4915117001 GREAT WEST
Other 54920 GREAT WEST
MEDICAID 207950916 GREAT WEST
Other 110257 GREAT WEST
Other P00007539 GREAT WEST

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