Provider Demographics
NPI:1245232602
Name:KASPER, GREGORY C (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:C
Last Name:KASPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 WESTON RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3602
Mailing Address - Country:US
Mailing Address - Phone:419-340-3511
Mailing Address - Fax:
Practice Address - Street 1:3100 WESTON RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3602
Practice Address - Country:US
Practice Address - Phone:866-320-4573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-2613-K2086S0129X
FLME1738842086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03988OtherPARAMOUNT
OH2551503Medicaid
MI4289285Medicaid
GA770002666Medicare UPIN
MI4289285Medicaid
OH2551503Medicaid
MIN98710001Medicare UPIN