MEDICARE: DR. LOUIS BAIRD KASUNIC D.O.

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	207Q00000X	Family Medicine Physician	28038	CO
2	207Q00000X	Family Medicine Physician	34.003912	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912083296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS BAIRD KASUNIC D.O.

Provider Business Mailing Address
First Line	:	755 S PERRY ST
Second Line	:	SUITE 100
City	:	CASTLE ROCK
State	:	CO
Zip	:	80104-1901
Country	:	US
Telephone Number	:	303-688-8989
Fax Number	:	303-688-3482

Provider Business Practice Location Address
First Line	:	755 S PERRY ST
Second Line	:	SUITE 100
City	:	CASTLE ROCK
State	:	CO
Zip	:	80104-1901
Country	:	US
Telephone Number	:	303-688-8989
Fax Number	:	303-688-3482

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

Provider Enumeration Date	:	10/28/2006
Last Update Date	:	07/08/2007

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