MEDICARE: DEAN RANDALL CHASSAY MD

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	207L00000X	Anesthesiology Physician	24930	AL
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	24930	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00329806	OTHER	AL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	051534597	OTHER	AL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629030648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEAN RANDALL CHASSAY MD

Provider Business Mailing Address
First Line	:	PO BOX 1547
Second Line	:
City	:	SEDALIA
State	:	MO
Zip	:	65302-1547
Country	:	US
Telephone Number	:	660-826-5960
Fax Number	:	660-826-4852

Provider Business Practice Location Address
First Line	:	8000 AL HIGHWAY 69
Second Line	:	MARSHALL MEDICAL CENTER NORTH
City	:	GUNTERSVILLE
State	:	AL
Zip	:	35976-7140
Country	:	US
Telephone Number	:	256-571-8000
Fax Number	:

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

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	10/20/2011

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Directions to “ DEAN RANDALL CHASSAY MD” Practice Location

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