Individual
JUSTIN DEREK CAUGHRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
(678) 312-4440
Mailing address
PO BOX 1746, INDIANAPOLIS, IN 46206-1746
(855) 206-4923
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
068491
GA
2085R0202X
Diagnostic Radiology Physician
N2024
TX
2085R0204X
Vascular & Interventional Radiology Physician
Primary
68491
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003153633
—
GA
Enumeration date
05/31/2008
Last updated
05/27/2021
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