Provider Demographics
NPI:1205221629
Name:MCCASLIN, LAUREN HALL (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:HALL
Last Name:MCCASLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ANN
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 S 52ND ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8600
Mailing Address - Country:US
Mailing Address - Phone:479-254-9662
Mailing Address - Fax:
Practice Address - Street 1:500 S 52ND ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8600
Practice Address - Country:US
Practice Address - Phone:479-254-9662
Practice Address - Fax:479-254-9652
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-12285207N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty