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General NPI Number Information
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NPI Number | 1093739906
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Entity Type | Individual
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Provider Name | CASEY PATRICK MD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 04/15/2020
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Provider Practice Location Address
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Address Line | 701 W PLYMOUTH AVE
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City | DELAND
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State | FL
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Zip | 32720-3236
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Country | US
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Telephone | 321-209-4303
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9430
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City | DAYTONA BEACH
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State | FL
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Zip | 32120-9430
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Country | US
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Telephone | 386-274-7800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 01060942A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME144799
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | N4655
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License Number State | TX
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