Provider Demographics
NPI:1467498220
Name:CASSAT, JAMES D (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:CASSAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 PATIENTS FIRST DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-4700
Mailing Address - Country:US
Mailing Address - Phone:636-239-7727
Mailing Address - Fax:636-239-5021
Practice Address - Street 1:901 PATIENTS FIRST DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-4700
Practice Address - Country:US
Practice Address - Phone:636-239-7727
Practice Address - Fax:636-239-5021
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3E56208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
020045289OtherRAILROAD MEDICARE
MO1467498220Medicaid
MO202037800Medicaid
MOP01192908OtherRAILROAD MEDICARE
A13603Medicare UPIN
MO202037800Medicaid
MOMA2536025Medicare PIN