Healthcare Provider Details

I. General information

NPI: 1962537027
Provider Name (Legal Business Name): JOHN S CASKEY M.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 LUISA ST UNIT I
SANTA FE NM
87505-4073
US

IV. Provider business mailing address

1421 LUISA ST STE I
SANTA FE NM
87505-4073
US

V. Phone/Fax

Practice location:
  • Phone: 505-982-8338
  • Fax: 505-982-8393
Mailing address:
  • Phone: 505-982-8338
  • Fax: 505-982-8393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberMD2006-0456
License Number StateNM

VIII. Authorized Official

Name: DR. JOHN S CASKEY
Title or Position: OWNER/MANAGING MEMBER
Credential:
Phone: 505-982-8338