| John S Caskey M.d., Llc | |
|
1421 Luisa St Unit I Santa Fe NM 87505-4073 | |
| (505) 982-8338 | |
| (505) 982-8393 |
| Full Name | John S Caskey M.d., Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1421 Luisa St, Santa Fe, New Mexico |
| Authorized Official Name and Position | John S Caskey (OWNER) |
| Authorized Official Contact | 5059828338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John S Caskey M.d., Llc 1421 Luisa St Unit I Santa Fe NM 87505-4073 Ph: (505) 982-8338 | John S Caskey M.d., Llc 1421 Luisa St Unit I Santa Fe NM 87505-4073 Ph: (505) 982-8338 |
| NPI Number | 1962537027 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 02/09/2010 |
| Medicare PECOS PAC ID | 8820197684 |
|---|---|
| Medicare Enrollment ID | O20070620000472 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962537027 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD2006-0456 (New Mexico) | Primary |
| 261QP3300X | Clinic/center - Pain | MD2006-0456 (New Mexico) | Secondary |
| Provider Name | John S Caskey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417061391 PECOS PAC ID: 8426054784 Enrollment ID: I20061101000578 |
| Provider Name | Deirdre C Grimes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023430345 PECOS PAC ID: 6800012451 Enrollment ID: I20140717001051 |
| Provider Name | Elizabeth G Mulhall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730540451 PECOS PAC ID: 6204125594 Enrollment ID: I20160510000090 |
| Provider Name | Alyssa R Stramel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356986947 PECOS PAC ID: 0446684708 Enrollment ID: I20191220000408 |
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