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General NPI Number Information
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NPI Number | 1275642191
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Entity Type | Individual
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Provider Name | JOHN B CASPER M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 9030 N HESS ST STE 474
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City | HAYDEN
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State | ID
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Zip | 83835-9827
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Country | US
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Telephone | 208-514-0518
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Fax | 208-486-4009
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Provider Business Mailing Address
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Address Line | 9030 N HESS ST STE 474
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City | HAYDEN
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State | ID
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Zip | 83835-9827
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Country | US
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Telephone | 208-514-0518
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Fax | 208-486-4009
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M4860
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | M4860
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License Number State | ID
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