MEDICARE: DR. DAVID GENE KASTL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	05487R	LA
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	29376	SC

General Provider Information

NPI Number	:	1679573125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID GENE KASTL M.D.

Provider Business Mailing Address
First Line	:	2001 CLAUDETTE CT
Second Line	:
City	:	BILOXI
State	:	MS
Zip	:	39531-2420
Country	:	US
Telephone Number	:	212-226-7777
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 CLAUDETTE CT
Second Line	:
City	:	BILOXI
State	:	MS
Zip	:	39531-2420
Country	:	US
Telephone Number	:	212-226-7777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	01/15/2019

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