Individual
MICHAEL THOMAS CASNELLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9300 STONESTREET RD, LOUISVILLE, KY 40272-2863
(502) 935-8061
(502) 933-7010
Mailing address
3615 NEWBURG RD, LOUISVILLE, KY 40218-3368
(502) 583-1011
(855) 859-0123
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
39494
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0343740001
MEDICARE DME GRP #
KY
01
—
2448515000
PASSPORT ADVANTAGE
KY
01
—
50007360
PASSPORT
KY
01
—
50040105
PASSPORT HEALTH-NORTON LEATHERMAN SPINE
KY
05
—
64104706
—
KY
01
—
771665
ANTHEM- NORTON LEATHERMAN SPINE
KY
01
—
K046980
MEDICARE- NORTON LEATHERMAN SPINE
KY
01
—
P00314315
RAILROAD MEDICARE
KY
Enumeration date
07/22/2005
Last updated
07/29/2021
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