Provider Demographics
NPI:1285685438
Name:KASTL, JAROD S (OD)
Entity Type:Individual
Prefix:DR
First Name:JAROD
Middle Name:S
Last Name:KASTL
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 1:2106 TAYLOR AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-4635
Mailing Address - Country:US
Mailing Address - Phone:402-347-4767
Mailing Address - Fax:
Practice Address - Street 1:2106 TAYLOR AVE STE 100
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701
Practice Address - Country:US
Practice Address - Phone:402-347-4767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1208152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEU99534Medicare UPIN
NE279094Medicare ID - Type Unspecified