MEDICARE: MR. CASEY DILLON PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	3100	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3100	OTHER	TN	STATE OF TN PA LICENSE

General Provider Information

NPI Number	:	1184175739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CASEY DILLON PA

Provider Business Mailing Address
First Line	:	181 MATHERLY ST
Second Line	:
City	:	CROSSVILLE
State	:	TN
Zip	:	38555-1001
Country	:	US
Telephone Number	:	931-644-5423
Fax Number	:	931-710-5728

Provider Business Practice Location Address
First Line	:	181 MATHERLY ST
Second Line	:
City	:	CROSSVILLE
State	:	TN
Zip	:	38555-1001
Country	:	US
Telephone Number	:	931-644-5423
Fax Number	:	931-710-5728

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2016
Last Update Date	:	05/13/2026

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Directions to “ MR. CASEY DILLON PA” Practice Location

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