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NPI Code Detail

MEDICARE: MS. MICHELLE LYNN MCCASKILL PA

MEDICARE: MS. MICHELLE LYNN MCCASKILL 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
1363A00000XPhysician AssistantTEMPTX

General Provider Information

NPI Number : 1235278292
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELLE LYNN MCCASKILL PA
Provider Business Mailing Address
First Line : 1205 N 6TH ST
Second Line :
City : LONGVIEW
State : TX
Zip : 75601-5539
Country : US
Telephone Number : 903-230-0235
Fax Number : 903-230-0242
Provider Business Practice Location Address
First Line : 1205 N 6TH ST
Second Line :
City : LONGVIEW
State : TX
Zip : 75601-5539
Country : US
Telephone Number : 903-230-0235
Fax Number : 903-230-0242
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2007
Last Update Date : 05/01/2017

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