Provider Demographics
NPI:1063774172
Name:CASE, CHAD KENNETH (MS, PA-C)
Entity type:Individual
Prefix:MR
First Name:CHAD
Middle Name:KENNETH
Last Name:CASE
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Gender:M
Credentials:MS, PA-C
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Mailing Address - Street 1:1100 E MICHIGAN AVE STE 307
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1850
Mailing Address - Country:US
Mailing Address - Phone:517-205-1594
Mailing Address - Fax:517-205-1540
Practice Address - Street 1:1100 E MICHIGAN AVE STE 307
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1850
Practice Address - Country:US
Practice Address - Phone:517-205-1594
Practice Address - Fax:517-205-1540
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2021-02-26
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Provider Licenses
StateLicense IDTaxonomies
MN5601006342363A00000X
MI5601006342363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant