Healthcare Provider Details

I. General information

NPI: 1417061391
Provider Name (Legal Business Name): JOHN S CASKEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2006
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:
Mailing address:
  • Phone: 505-982-8338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD2006-0456
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD20060456
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: