Provider Demographics
NPI:1366582660
Name:CASKEY, BRYAN D (PA)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:D
Last Name:CASKEY
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:148 LINDEN DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6909
Mailing Address - Country:US
Mailing Address - Phone:540-504-0066
Mailing Address - Fax:540-678-9025
Practice Address - Street 1:94 BROOKSHIRE LN
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-6765
Practice Address - Country:US
Practice Address - Phone:304-252-2673
Practice Address - Fax:304-929-2350
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2017-03-01
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Provider Licenses
StateLicense IDTaxonomies
WV480363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1366582660Medicaid
WV1366582660Medicaid