Provider Demographics
NPI:1265448526
Name:KASE, SPEELMAN, &CULLEN, M.D.'S, INC.
Entity Type:Organization
Organization Name:KASE, SPEELMAN, &CULLEN, M.D.'S, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KASE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-723-3256
Mailing Address - Street 1:970 E WASHINGTON ST
Mailing Address - Street 2:STE 4B
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-3332
Mailing Address - Country:US
Mailing Address - Phone:330-723-3256
Mailing Address - Fax:330-722-6731
Practice Address - Street 1:970 E WASHINGTON ST
Practice Address - Street 2:STE 4B
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-3332
Practice Address - Country:US
Practice Address - Phone:330-723-3256
Practice Address - Fax:330-722-6731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCG5910OtherRAILROAD MEDICARE
OH100462OtherKAISER
OH2192961Medicaid
OH100462OtherKAISER
OH100462OtherKAISER