Individual
DR. MARK ALLEN CASEBOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1541 SW 1ST AVE STE 105, OCALA, FL 34471-6506
(352) 622-8152
(352) 622-4408
Mailing address
1541 SW 1ST AVE, SUITE 105, OCALA, FL 34471
(352) 622-8152
(352) 622-4408
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME109242
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003506600
—
FL
01
—
14C2E
BCBS OF FLORIDA
FL
01
—
MB090
MEDICARE - FL
FL
01
—
ME109242
STATE LICENSE
FL
Enumeration date
06/06/2006
Last updated
01/22/2021
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