Individual
JONATHAN S. C. CAUDILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1203 MEDICAL PARK DR, OXFORD, MS 38655-5327
(662) 513-4399
Mailing address
1203 MEDICAL PARK DR, OXFORD, MS 38655-5327
(662) 513-4399
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
18119
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
590057300
—
MN
Enumeration date
02/03/2006
Last updated
02/09/2010
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