Provider Demographics
NPI:1598012411
Name:CASEY, JASON (BC-HIS)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:CASEY
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6380 U S HIGHWAY 98 WEST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-8399
Mailing Address - Country:US
Mailing Address - Phone:601-602-4147
Mailing Address - Fax:601-909-6157
Practice Address - Street 1:6380 U S HIGHWAY 98 WEST
Practice Address - Street 2:SUITE 1
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-8399
Practice Address - Country:US
Practice Address - Phone:601-602-4147
Practice Address - Fax:601-909-6157
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSHA0578237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist