Provider Demographics
NPI:1518251123
Name:MCCASKILL, JANAWA I (PT)
Entity Type:Individual
Prefix:MR
First Name:JANAWA
Middle Name:
Last Name:MCCASKILL
Suffix:I
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 LOWER LOUISVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MS
Mailing Address - Zip Code:39095-8210
Mailing Address - Country:US
Mailing Address - Phone:662-834-4919
Mailing Address - Fax:
Practice Address - Street 1:2320 LOWER LOUISVILLE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MS
Practice Address - Zip Code:39095-8210
Practice Address - Country:US
Practice Address - Phone:662-834-4919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT- 1695225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist