Provider Demographics
NPI:1134239171
Name:CASANO, PETER J (MD)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:J
Last Name:CASANO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2550 FLOWOOD DR
Mailing Address - Street 2:402
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9303
Mailing Address - Country:US
Mailing Address - Phone:601-932-5244
Mailing Address - Fax:601-939-0545
Practice Address - Street 1:1038 RIVER OAKS DR
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232
Practice Address - Country:US
Practice Address - Phone:601-932-5244
Practice Address - Fax:601-939-0545
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2019-06-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS12096207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00126164Medicaid
MS00126164Medicaid
D89677Medicare UPIN