NPI 1003137084

Jason P Eastlack, MD

Practitioner Diagnostic Radiology Physician Columbia, SC

Practice location

Address: 1519 Marion St, Columbia, SC 29201-2910
Phone: (803) 296-5954
Fax: (803) 296-3076
Mailing address: 300 E McBee Ave Fl 4, Greenville, SC 29601-2842

Registered specialties (3)

Diagnostic Radiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence 52431 (SC)

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Diagnostic Radiology Physician

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence 24394 (MS)

Diagnostic Radiology Physician

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence P2434 (TX)

Registry record

NPI: 1003137084
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Jun 2010
Record last updated: 11 Nov 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.