Provider Demographics
NPI:1841534104
Name:JOST, CASEY A (HIS)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:A
Last Name:JOST
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8217 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-9310
Mailing Address - Country:US
Mailing Address - Phone:414-761-2700
Mailing Address - Fax:414-761-2711
Practice Address - Street 1:8217 27TH STREET
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53232
Practice Address - Country:US
Practice Address - Phone:414-761-2700
Practice Address - Fax:414-761-2711
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1231237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist