Provider Demographics
NPI:1669457131
Name:CAETON, ANTHONY JOHN III (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOHN
Last Name:CAETON
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:1040 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-6416
Mailing Address - Country:US
Mailing Address - Phone:740-383-7936
Mailing Address - Fax:740-375-8174
Practice Address - Street 1:1000 MCKINLEY PARK DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6399
Practice Address - Country:US
Practice Address - Phone:740-383-8400
Practice Address - Fax:740-375-8174
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2004-04602080N0001X
OH35-0765332080N0001X
CAG499142080N0001X
CO424082080N0001X
AK30842080N0001X
UT5344254-12052080N0001X
KS04-304262080N0001X
PAMD4219582080N0001X
MI43010825102080N0001X
ND100622080N0001X
KY378822080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM05735360Medicaid
OH2148509Medicaid
A51508Medicare UPIN
OHH22660Medicare PIN