Provider Demographics
NPI:1104135193
Name:MCCASLIN, STEVE M (DPH)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:M
Last Name:MCCASLIN
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:ETOWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37331-2712
Mailing Address - Country:US
Mailing Address - Phone:423-263-4313
Mailing Address - Fax:423-263-4316
Practice Address - Street 1:733 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:ETOWAH
Practice Address - State:TN
Practice Address - Zip Code:37331-2712
Practice Address - Country:US
Practice Address - Phone:423-263-4313
Practice Address - Fax:423-263-4316
Is Sole Proprietor?:No
Enumeration Date:2010-09-25
Last Update Date:2010-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3782183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist