Healthcare Provider Details

I. General information

NPI: 1376579383
Provider Name (Legal Business Name): JOHN M. KAST MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1948 AL HIGHWAY 157
CULLMAN AL
35058-0642
US

IV. Provider business mailing address

PO BOX 2895
CULLMAN AL
35056-2895
US

V. Phone/Fax

Practice location:
  • Phone: 256-735-5560
  • Fax: 256-801-7364
Mailing address:
  • Phone: 256-735-5044
  • Fax: 256-801-7626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberMD.32612
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: