Provider Demographics
NPI:1114112729
Name:GARRETT, CASSANDRA ANN (DO)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:ANN
Last Name:GARRETT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 AIRPORT GARDENS RD
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9529
Mailing Address - Country:US
Mailing Address - Phone:606-377-3427
Mailing Address - Fax:606-439-6987
Practice Address - Street 1:100 AIRPORT GARDENS RD
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9529
Practice Address - Country:US
Practice Address - Phone:606-377-3427
Practice Address - Fax:606-439-6987
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY03029207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine