Provider Demographics
NPI:1881688216
Name:CASCAIRO, MARK ANTHONY (DO)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ANTHONY
Last Name:CASCAIRO
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:PO BOX 505164
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-5164
Mailing Address - Country:US
Mailing Address - Phone:417-829-4620
Mailing Address - Fax:417-829-4316
Practice Address - Street 1:1229 E SEMINOLE ST
Practice Address - Street 2:SUITE 420
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2227
Practice Address - Country:US
Practice Address - Phone:417-820-9393
Practice Address - Fax:417-820-9725
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2015-08-05
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Provider Licenses
StateLicense IDTaxonomies
OK2776207W00000X
MO111966207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1881688216Medicaid
OK100178010Medicaid
OK248522201Medicare ID - Type UnspecifiedMEDICARE
OK100178010Medicaid
MO132680687Medicare PIN