Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | MD10666 | OR |
NPI | 1023103546 |
---|---|
Provider Name | Michael F. Mccaskill |
First Address | Grants Pass, OR 97526 |
Second Address | Grants Pass, OR 97526 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F30620 | (02) | OR |