Basic Information
| Provider Information | |||||||||
| NPI: | 1831363829 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CASEY | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | RANDOLPH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O., M.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5100 W BROAD ST | ||||||||
| Address2: | DEPT OF EMERGENCY MEDICINE | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432281607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145441047 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5100 W BROAD ST | ||||||||
| Address2: | DEPARTMENT OF EMERGENCY MEDICINE | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432281607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145442780 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2008 | ||||||||
| LastUpdateDate: | 06/11/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 34.009926 | OH | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.