Provider Demographics
NPI:1891793956
Name:KASA, ROBERT F (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:F
Last Name:KASA
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 1:127 LEDFORD MILL RD STE B
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-2278
Mailing Address - Country:US
Mailing Address - Phone:931-841-3311
Mailing Address - Fax:931-841-3314
Practice Address - Street 1:127 LEDFORD MILL RD STE B
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2278
Practice Address - Country:US
Practice Address - Phone:931-841-3311
Practice Address - Fax:931-841-3314
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN66822208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ242016Medicaid
AZZ85794Medicare PIN