Provider Demographics
NPI:1003887928
Name:KASTER, BRAD PHILLIP (OD)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:PHILLIP
Last Name:KASTER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E TURKEYFOOT LAKE RD STE A
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-5365
Mailing Address - Country:US
Mailing Address - Phone:330-899-7161
Mailing Address - Fax:330-899-7151
Practice Address - Street 1:1600 E TURKEYFOOT LAKE RD STE A
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-5365
Practice Address - Country:US
Practice Address - Phone:330-899-7161
Practice Address - Fax:330-899-7151
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5557152W00000X
COOPT.0003172152W00000X
FL4032152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
V02095Medicare UPIN