East, Mary Jean

East, Mary Jean is an sole proprietor health care provider with primary practice located at 539 Hardee St , Dallas GA 30132-4711. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. East, Mary Jean can be contacted via phone (770) 505-0531.

Contact Information

Primary practice address
539 Hardee St Dallas GA 30132-4711
Phone: (770) 505-0531
Fax: (770) 485-0570
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN032537 Georgia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 063187 Georgia

Profile Details

NPI number 1225091341
LBN Legal business name East, Mary Jean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 10th, 2006
Last updated Aug 8th, 2012 - about 12 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 1225091341 NPPES
Georgia MEDICAID 000430515A
Georgia MEDICAID 085000588G

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