Provider Demographics
NPI:1518998889
Name:MCCASKILL, CLEMENT LEON (DO)
Entity Type:Individual
Prefix:DR
First Name:CLEMENT
Middle Name:LEON
Last Name:MCCASKILL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1717
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27533-1717
Mailing Address - Country:US
Mailing Address - Phone:919-587-4081
Mailing Address - Fax:919-580-0148
Practice Address - Street 1:1506 WAYNE MEMORIAL DR
Practice Address - Street 2:SUITE D
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2202
Practice Address - Country:US
Practice Address - Phone:919-736-0767
Practice Address - Fax:919-580-0148
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28928207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP01339944OtherRAILROAD MEDICARE
NC8955739Medicaid
NC8955739Medicaid
NCP01339944OtherRAILROAD MEDICARE
NC561677616OtherBMS/BENEFIT MANAGEMENT
NC561677616OtherCIGNA HEALTHCARE
204144Medicare PIN
NC55739OtherBLUE CROSS
NC561677616OtherKANAWHA INSURANCE COMPANY
NY561677616OtherAETNA
NC561677616OtherBRIDGESTONE
NC561677616OtherACS BENEFIT SERVICES,INC.
NC561677616OtherBANKERS LIFE AND CASUALTY
NCC82334Medicare UPIN
NC561677616OtherAMERICAN REPUBLIC INSURAN
NC561677616OtherCAROLINA SUMMIT
NC561677616OtherACORDIA NATIONAL
NC8955739Medicaid
NC561677616OtherCOMMERCIAL INSURANCE
NC561677616OtherCBCA ADMINISTRATORS.INC.