Provider Demographics
NPI:1225424344
Name:EWING CASEY, KAILY (DO)
Entity Type:Individual
Prefix:
First Name:KAILY
Middle Name:
Last Name:EWING CASEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 MERCY RD STE 2000
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2323
Mailing Address - Country:US
Mailing Address - Phone:402-717-4909
Mailing Address - Fax:402-717-6068
Practice Address - Street 1:7710 MERCY RD STE 2000
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2323
Practice Address - Country:US
Practice Address - Phone:402-717-4909
Practice Address - Fax:402-717-6068
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-15
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2380208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery