Individual
MR. JASON W CASWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
15476 DEDEAUX RD, GULFPORT, MS 39503-2637
(228) 230-2663
(228) 546-3257
Mailing address
6300 E LAKE BLVD STE 301, VANCLEAVE, MS 39565-6771
(228) 230-2663
(228) 546-3257
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00199
MS
363AS0400X
Surgical Physician Assistant
PA00199
MS
Other
Enumeration date
01/22/2014
Last updated
01/16/2020
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