Healthcare Provider Details

I. General information

NPI: 1083141592
Provider Name (Legal Business Name): DANIEL JAMES CASEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2017
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W THOMAS RD
PHOENIX AZ
85013-4409
US

IV. Provider business mailing address

11339 S PIKES PEAK DR
PARKER CO
80138-7333
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-3153
  • Fax: 602-406-7186
Mailing address:
  • Phone: 623-297-6465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberDR.0072373
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: