Provider Demographics
NPI:1790718658
Name:MELTON, CASEY WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:WAYNE
Last Name:MELTON
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:PO BOX 7987
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36670-0987
Mailing Address - Country:US
Mailing Address - Phone:251-633-0573
Mailing Address - Fax:251-633-7367
Practice Address - Street 1:5955 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608
Practice Address - Country:US
Practice Address - Phone:251-633-0573
Practice Address - Fax:251-633-7367
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25927207RC0200X, 207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL6888933OtherCIGNA HC
MS09872501OtherMS MEDICAID
AL512-07812OtherBCBS
AL515-91165OtherBCBS
ALP00620269OtherRR MEDICARE
ALI09368OtherVIVA HEALTH
AL101717Medicaid
AL102I113605OtherMEDICARE
AL215552Medicaid
AL220633Medicaid
AL221415Medicaid
AL214754Medicaid
AL9127183OtherAETNA
AL518-07813OtherBCBS
AL2930459OtherUHC