Healthcare Provider Details

I. General information

NPI: 1912078254
Provider Name (Legal Business Name): KEVIN CASEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 HEALTH CAMPUS DR STE 200
ROCKINGHAM VA
22801-8679
US

IV. Provider business mailing address

2006 HEALTH CAMPUS DR STE 200
ROCKINGHAM VA
22801-8679
US

V. Phone/Fax

Practice location:
  • Phone: 540-689-5555
  • Fax:
Mailing address:
  • Phone: 540-689-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number51859
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD030954E
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number0101255444
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: