Kacie Cassaday, D.O.
Family Medicine in Shawnee, OK. Individual provider (NPI-1).
NPI number1669790598
StatusActive
Last updated in NPPESMar 9, 2022
Details
- NPI
- 1669790598
- Entity type
- Individual (NPI-1)
- Name
- Kacie Cassaday
- Credential
- D.O.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 17, 2010
- Certification date
- Mar 9, 2022
- Last updated
- Mar 9, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 5720 | OK | Yes |
| 207QS0010X | Family Medicine, Sports Medicine | 5720 | OK |
Practice location
4651 N Harrison StShawnee, OK 74804-1440
Phone 405-214-1500 · Fax 405-214-1507
Mailing address
4651 N Harrison StShawnee, OK 74804-1440
Phone 405-214-1500 · Fax 405-214-1507
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