Provider Demographics
NPI:1659810521
Name:CASLIN, LASUNDRA
Entity Type:Individual
Prefix:
First Name:LASUNDRA
Middle Name:
Last Name:CASLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 FLOATING LEAF WAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-7596
Mailing Address - Country:US
Mailing Address - Phone:423-313-2597
Mailing Address - Fax:
Practice Address - Street 1:337 FLOATING LEAF WAY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-7596
Practice Address - Country:US
Practice Address - Phone:423-313-2597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical