Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | DR-49601 | CO |
Y | 207Q00000X | Family Doctor | E-3759 | AR |
N | 207QS0010X | Family Doctor - Sports Medicine | E-3759 | AR |
NPI | 1285662957 |
---|---|
Provider Name | Michael D Cassat |
First Address | Little Rock, AR 72205-7101 |
Second Address | Little Rock, AR 72205-7101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 02/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E-3759 | AR LICENSE (01) | AR |
H91745 | (02) | AR |