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Contact Information

ALBERT G CACCAVALE, DO
1003 WILLOW CREEK RD
PRESCOTT, AZ86301-1641
 Phone: 928-771-5420
 Fax: 928-771-5471
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hospitalist

208M00000X
 

Critical Care Medicine

207RC0200X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for ALBERT G CACCAVALE · (Male)

NPI # 1780670513
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 09/27/2005
Last updated 02/22/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # 1944
  • CO License # 47673
  • CO Medicaid 29826551
  • FL Medicaid 913113200
  • Other 109745 AHCCCS
  • Other 109745004 APIPA
  • Other AZ0744400 BCBS
Hospital affiliation(s)
  • YAVAPAI REGIONAL MEDICAL CENTER - (Acute Care)
    1003 WILLOW CREEK ROAD
    PRESCOTT, AZ 86301
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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