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General NPI Number Information
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NPI Number | 1922008192
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Entity Type | Individual
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Provider Name | JOHN D CAGGIANO M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 11/20/2014
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Provider Practice Location Address
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Address Line | 300 W COUNTRY CLUB RD SUITE #130
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City | ROSWELL
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State | NM
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Zip | 88201-5240
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Country | US
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Telephone | 575-624-4777
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Fax | 575-624-8711
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Provider Business Mailing Address
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Address Line | 300 W COUNTRY CLUB RD SUITE #130
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City | ROSWELL
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State | NM
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Zip | 88201-5240
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Country | US
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Telephone | 575-624-4777
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Fax | 575-624-8711
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD012076
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD2012-0238
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License Number State | NM
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