| Doctor Name: | DR. JAMES H. EASTLICK |
| NPI Number: | 1689795924 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | 97-23P |
| Business Practice Address: | Rr 1 Box 664 Box Elder, MT - 595219797 |
| Business Phone Number: | 4063954486 |
| Business Fax Number: | 4063954313 |
| Mailing Address: | 76 19th St, HAVRE |
| State: | MT |
| Postal Code: | 595015212 |
| Phone Number: | 4062653250 |
| Fax Number: | 4063954313 |
| NPI Enumeration Date: | 04/03/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 97-23P |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |