Provider Demographics
NPI:1376773994
Name:CASWELL, JASON HARRISON (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:HARRISON
Last Name:CASWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3229 E PERSHING BLVD
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-5769
Mailing Address - Country:US
Mailing Address - Phone:307-363-2054
Mailing Address - Fax:307-227-6817
Practice Address - Street 1:3229 E PERSHING BLVD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-5769
Practice Address - Country:US
Practice Address - Phone:307-363-2054
Practice Address - Fax:307-227-6817
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01071769A207Q00000X
WY11719A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine