Provider Demographics
NPI:1326086182
Name:KASICK, JAMES M (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:KASICK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:842 CORPORATE WAY
Mailing Address - Street 2:SUITE 850
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1537
Mailing Address - Country:US
Mailing Address - Phone:440-871-4700
Mailing Address - Fax:440-871-4702
Practice Address - Street 1:29099 HEALTH CAMPUS DR
Practice Address - Street 2:SUITE 330
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5200
Practice Address - Country:US
Practice Address - Phone:440-835-6278
Practice Address - Fax:440-835-6278
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2009-03-05
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Provider Licenses
StateLicense IDTaxonomies
OH35-04-0443-K207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH525284Medicaid
OH070000779OtherMEDICARE RAILROAD PIN
OH525284Medicaid
OH0533161Medicare PIN