Provider Demographics
NPI:1679573125
Name:KASTL, DAVID GENE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GENE
Last Name:KASTL
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 1:2001 CLAUDETTE CT
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39531-2420
Mailing Address - Country:US
Mailing Address - Phone:212-226-7777
Mailing Address - Fax:
Practice Address - Street 1:2001 CLAUDETTE CT
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-2420
Practice Address - Country:US
Practice Address - Phone:212-226-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA05487R208G00000X
SC29376208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
C67263Medicare UPIN
LA5L927Medicare ID - Type Unspecified