Provider Demographics
NPI:1972999365
Name:MCCASKILL, JENNIFER RENEE (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RENEE
Last Name:MCCASKILL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2900 HANNAH BLVD STE 216
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-5382
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10300 W 8 MILE RD
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-2100
Practice Address - Country:US
Practice Address - Phone:248-398-3200
Practice Address - Fax:248-691-4963
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301108310207QB0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine