Provider Demographics
NPI:1316965478
Name:CASEY, JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:CASEY
Suffix:
Gender:M
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:P.O. BOX 706
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-0706
Mailing Address - Country:US
Mailing Address - Phone:603-481-8757
Mailing Address - Fax:603-238-2163
Practice Address - Street 1:16 HOSPITAL ROAD
Practice Address - Street 2:SPEARE SURGICAL SERVICES
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264
Practice Address - Country:US
Practice Address - Phone:603-536-5670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9314174400000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH020025324OtherRAILROAD MEDICARE
NH30007490Medicaid
VT0RE3402Medicaid
NH0104398Y0NH02OtherANTHEM
NH3073200Medicaid
F54875OtherHARVARD PILGRIM
100779800OtherUS DEPT OF LABOR
213870OtherCIGNA
VTORE3402Medicaid
NH3073200Medicaid
213870OtherCIGNA
NHRE3402Medicare PIN
NHAX5127Medicare PIN