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General NPI Number Information
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NPI Number | 1396733051
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Entity Type | Organization
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Legal Business Name | ELDON E CASSELL MD PC
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Dates
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Enumeration Date | 10/07/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1009 W GREEN ST
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City | HASTINGS
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State | MI
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Zip | 49058-1710
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Country | US
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Telephone | 269-945-3451
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 74
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City | HASTINGS
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State | MI
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Zip | 49058-0074
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Country | US
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Telephone | 800-678-1861
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELDON CASSELL
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Credential | MD
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Telephone | 269-945-3451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State | MI
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