MEDICARE: DR. CLAYTON T CASHEN O.D.

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	152W00000X	Optometrist	18003655A	IN
2	152W00000X	Optometrist	4901005099	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720393507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLAYTON T CASHEN O.D.

Provider Business Mailing Address
First Line	:	PO BOX 549
Second Line	:
City	:	WABASH
State	:	IN
Zip	:	46992-0549
Country	:	US
Telephone Number	:	260-569-9550
Fax Number	:	260-569-9244

Provider Business Practice Location Address
First Line	:	4023 RED ARROW HWY
Second Line	:
City	:	SAINT JOSEPH
State	:	MI
Zip	:	49085-9209
Country	:	US
Telephone Number	:	269-983-3200
Fax Number	:	269-983-4902

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

Provider Enumeration Date	:	08/17/2010
Last Update Date	:	12/03/2024

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