Provider Demographics
NPI:1619954427
Name:CASANOVA, FRANCISCO AGUIRRE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:AGUIRRE
Last Name:CASANOVA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:FRANCISCO
Other - Middle Name:AGUIRRE
Other - Last Name:CASANOVA
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 729
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:AZ
Mailing Address - Zip Code:86025-0729
Mailing Address - Country:US
Mailing Address - Phone:928-524-2881
Mailing Address - Fax:928-524-2122
Practice Address - Street 1:415 E IOWA ST
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:AZ
Practice Address - Zip Code:86025-2748
Practice Address - Country:US
Practice Address - Phone:928-524-2881
Practice Address - Fax:928-524-2122
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15081207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1840615007OtherCIGNA HEALTH CARE
4549241OtherAETNA
AZ0014110OtherBLUE CROSS BLUE SHIELD
84317OtherUNIFIED HEALTH CARE
860383127OtherTRICARE
D36650Medicare UPIN