Provider Demographics
NPI:1720379498
Name:DELCOCO, CASEY L (MD)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:L
Last Name:DELCOCO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CASEY
Other - Middle Name:L
Other - Last Name:REISING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8240 NAAB RD STE 416
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5927
Mailing Address - Country:US
Mailing Address - Phone:317-306-5588
Mailing Address - Fax:317-550-1544
Practice Address - Street 1:8240 NAAB RD STE 416
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5927
Practice Address - Country:US
Practice Address - Phone:317-306-5588
Practice Address - Fax:317-550-1544
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-28
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01074227A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine