Provider Demographics
NPI:1982876140
Name:CASSAT FAMILY MEDICINE, PA
Entity Type:Organization
Organization Name:CASSAT FAMILY MEDICINE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:CASSAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:479-445-9222
Mailing Address - Street 1:1022 JONES RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-0705
Mailing Address - Country:US
Mailing Address - Phone:479-361-4631
Mailing Address - Fax:479-361-4649
Practice Address - Street 1:1022 JONES RD
Practice Address - Street 2:SUITE B
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0705
Practice Address - Country:US
Practice Address - Phone:479-361-4631
Practice Address - Fax:479-361-4649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE3759207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty