Provider Demographics
NPI:1053396937
Name:CASERTA, FRANK P (MD)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:P
Last Name:CASERTA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2600 S. RURAL RD SUITE B
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-2448
Mailing Address - Country:US
Mailing Address - Phone:480-967-3381
Mailing Address - Fax:480-967-0755
Practice Address - Street 1:2600 S. RURAL RD. SUITE B
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-2448
Practice Address - Country:US
Practice Address - Phone:480-967-3381
Practice Address - Fax:480-967-0755
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2018-09-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ25755207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ180043659OtherRAILROAD MEDICARE
AZ392986Medicaid
AZAZ0877450OtherBLUE CROSS BLUE SHIELD
AZZ63648Medicare ID - Type Unspecified