Healthcare Provider Details

I. General information

NPI: 1023657871
Provider Name (Legal Business Name): CASEY ALEXANDER MARSH PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2019
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 S MAIN ST
DANVILLE VA
24541-2922
US

IV. Provider business mailing address

142 S MAIN ST
DANVILLE VA
24541-2922
US

V. Phone/Fax

Practice location:
  • Phone: 434-799-2100
  • Fax:
Mailing address:
  • Phone: 434-799-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number13384
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: