Healthcare Provider Details

I. General information

NPI: 1790098416
Provider Name (Legal Business Name): INFINITY FAMILY PRACTICE ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2010
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 NEAL ST SUITE 103
COOKEVILLE TN
38501-0942
US

IV. Provider business mailing address

1080 NEAL ST SUITE 103
COOKEVILLE TN
38501-0942
US

V. Phone/Fax

Practice location:
  • Phone: 931-520-1529
  • Fax: 931-614-7517
Mailing address:
  • Phone:
  • Fax: 931-614-7517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL P CASAL
Title or Position: OWNER
Credential: M.D.
Phone: 931-526-3316