Provider Demographics
NPI:1881662468
Name:CASEY, HENRY R JR (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:R
Last Name:CASEY
Suffix:JR
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:27 PARK STREET
Mailing Address - Street 2:CAPE COD HOSPITAL-DAVENPORT-MUGAR CANCER CENTER
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601
Mailing Address - Country:US
Mailing Address - Phone:508-862-7575
Mailing Address - Fax:508-862-7362
Practice Address - Street 1:27 PARK STREET
Practice Address - Street 2:CAPE COD HOSPITAL-DAVENPORT-MUGAR CANCER CENTER
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-862-7575
Practice Address - Fax:508-862-7362
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA38951207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2054264Medicaid
MA60172OtherHPHC
MAB47160OtherBCBS
MA2054264Medicaid
MA60172OtherHPHC