Individual
CHARLES CADDY II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
485 N KS HWY 2, ANTHONY, KS 67003-2526
(620) 914-1200
(620) 914-1256
Mailing address
485 N KS HWY 2, ANTHONY, KS 67003-2526
(620) 914-1200
(620) 914-1256
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1500771
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100407220E
—
KS
Enumeration date
12/23/2005
Last updated
12/07/2020
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