Provider Demographics
NPI:1346756244
Name:MCCASLIN, DUSTIN W
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:W
Last Name:MCCASLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 SE 22ND ST
Mailing Address - Street 2:
Mailing Address - City:DEL CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73115-1543
Mailing Address - Country:US
Mailing Address - Phone:405-314-7899
Mailing Address - Fax:
Practice Address - Street 1:3505 SE 22ND ST
Practice Address - Street 2:
Practice Address - City:DEL CITY
Practice Address - State:OK
Practice Address - Zip Code:73115-1543
Practice Address - Country:US
Practice Address - Phone:405-314-7899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator