Provider Demographics
NPI:1073614723
Name:OPERE, CAXTON ADEREMI (MD)
Entity type:Individual
Prefix:DR
First Name:CAXTON
Middle Name:ADEREMI
Last Name:OPERE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7715 TOM DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-2321
Mailing Address - Country:US
Mailing Address - Phone:225-892-5270
Mailing Address - Fax:
Practice Address - Street 1:639 LOTUS DRIVE N
Practice Address - Street 2:SUITE B
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70470
Practice Address - Country:US
Practice Address - Phone:985-626-6133
Practice Address - Fax:985-626-6136
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC166102207R00000X
OH35.129510207P00000X
CT80189207R00000X, 208M00000X
LA13764R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1434892Medicaid
LA5H945Medicare ID - Type Unspecified
LA1434892Medicaid