Basic Information
Provider Information
NPI: 1740508571
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EASON
FirstName: MARGOT
MiddleName: BELL
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BELL
OtherFirstName: MARGOT
OtherMiddleName: MARION
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 130 DESIARD ST
Address2: SUITE 355
City: MONROE
State: LA
PostalCode: 712017319
CountryCode: US
TelephoneNumber: 3188077875
FaxNumber: 3188126603
Practice Location
Address1: 920 OLIVER RD
Address2:  
City: MONROE
State: LA
PostalCode: 712015702
CountryCode: US
TelephoneNumber: 3188076263
FaxNumber: 3188127348
Other Information
ProviderEnumerationDate: 05/04/2010
LastUpdateDate: 06/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XMD.205572LAY Allopathic & Osteopathic PhysiciansPediatrics 

ID Information
IDTypeStateIssuerDescription
210285105LA MEDICAID


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