| Doctor Name: | PATRICK MICHAEL CASSIDY |
| NPI Number: | 1063666824 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A.-C |
| License Number: | 2941 |
| Business Practice Address: | 350 Lyckman Pl Fountain, CO - 808172861 |
| Business Phone Number: | 7193220777 |
| Business Fax Number: | 7193220776 |
| Mailing Address: | 3205 N Academy Blvd, Suite 130 COLORADO SPRINGS |
| State: | CO |
| Postal Code: | 809175101 |
| Phone Number: | 7196325700 |
| Fax Number: | 7193447837 |
| NPI Enumeration Date: | 11/06/2008 |
| NPI Last Update Date: | 11/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 2941 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |