Provider Demographics
NPI:1245466408
Name:CASON, JOSHUA RAY (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:RAY
Last Name:CASON
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 1:225 BILLY HOLMAN RD
Mailing Address - Street 2:
Mailing Address - City:CAMPTI
Mailing Address - State:LA
Mailing Address - Zip Code:71411
Mailing Address - Country:US
Mailing Address - Phone:318-423-4385
Mailing Address - Fax:318-932-2211
Practice Address - Street 1:1635 MARVEL ST
Practice Address - Street 2:
Practice Address - City:COUSHATTA
Practice Address - State:LA
Practice Address - Zip Code:71019-9022
Practice Address - Country:US
Practice Address - Phone:318-932-2085
Practice Address - Fax:318-932-2211
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.204298207Q00000X
LA204298207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2140086Medicaid
LAP01248501OtherRR MEDICARE
LA2140086Medicaid
LAP01248501OtherRR MEDICARE
LA249170YJV6Medicare PIN
LA246103YH9ZMedicare PIN
LA4P9475CP63Medicare PIN