Healthcare Provider Details

I. General information

NPI: 1124148358
Provider Name (Legal Business Name): GARRICK W. CASON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 10/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 DUNHILL PL NW STE A
CLEVELAND TN
37311-3885
US

IV. Provider business mailing address

102 DUNHILL PL NW STE A
CLEVELAND TN
37311-3885
US

V. Phone/Fax

Practice location:
  • Phone: 423-728-1650
  • Fax: 423-728-1655
Mailing address:
  • Phone: 423-728-1650
  • Fax: 423-728-1655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number46038
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: