Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 46038 | TN |
NPI | 1124148358 |
---|---|
Provider Name | Dr. Garrick W. Cason |
First Address | Cleveland, TN 37311-3885 |
Second Address | Cleveland, TN 37311-3885 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2007 |
Last Update Date | 04/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3035497 | BCBST (01) | TN |
3710154 | (05) | TN |