Healthcare Provider Details

I. General information

NPI: 1245466408
Provider Name (Legal Business Name): JOSHUA RAY CASON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2009
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 MARVEL ST
COUSHATTA LA
71019-9022
US

IV. Provider business mailing address

225 BILLY HOLMAN RD
CAMPTI LA
71411
US

V. Phone/Fax

Practice location:
  • Phone: 318-932-2085
  • Fax: 318-932-2211
Mailing address:
  • Phone: 318-423-4385
  • Fax: 318-932-2211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.204298
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number204298
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: