MEDICARE: PHILIP C CASWELL D.P.M.

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	213ES0103X	Foot & Ankle Surgery Podiatrist	MD002494	NJ

General Provider Information

NPI Number	:	1467428904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP C CASWELL D.P.M.

Provider Business Mailing Address
First Line	:	122 N CHURCH RD
Second Line	:
City	:	SPARTA
State	:	NJ
Zip	:	07871-3204
Country	:	US
Telephone Number	:	973-300-9151
Fax Number	:	973-300-9175

Provider Business Practice Location Address
First Line	:	122 N CHURCH RD
Second Line	:
City	:	SPARTA
State	:	NJ
Zip	:	07871-3204
Country	:	US
Telephone Number	:	973-300-9151
Fax Number	:	973-300-9175

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

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	12/20/2007

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