Provider Demographics
NPI:1447929963
Name:DIANA L EASTON
Entity type:Organization
Organization Name:DIANA L EASTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:EASTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:928-472-9480
Mailing Address - Street 1:708 E STATE HIGHWAY 260 STE B1
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541-5095
Mailing Address - Country:US
Mailing Address - Phone:928-472-9480
Mailing Address - Fax:928-472-6176
Practice Address - Street 1:708 E STATE HIGHWAY 260 STE B1
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-5095
Practice Address - Country:US
Practice Address - Phone:928-472-9480
Practice Address - Fax:928-472-6176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty