Provider Demographics
NPI:1508021007
Name:CASKEY, ROBERT CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CHARLES
Last Name:CASKEY
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 1:1365 CLIFTON RD NE
Mailing Address - Street 2:CLINIC A, 4TH FLOOR
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1013
Mailing Address - Country:US
Mailing Address - Phone:404-778-3712
Mailing Address - Fax:
Practice Address - Street 1:1365 CLIFTON ROAD NE
Practice Address - Street 2:CLINIC A, 4TH FLOOR
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-4551
Practice Address - Country:US
Practice Address - Phone:404-778-3712
Practice Address - Fax:404-778-5003
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS21411208600000X
PAMD448480208600000X
GA90522208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102838120Medicaid
PA102838120Medicaid