Individual
DR. FRED M. CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 PHYSICIANS PARK STE 400, POPLAR BLUFF, MO 63901-3923
(573) 727-5500
(573) 727-5599
Mailing address
PO BOX 801143, KANSAS CITY, MO 64180-1143
(573) 331-5583
(573) 331-5079
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36656
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202642906
—
MO
Enumeration date
06/01/2006
Last updated
01/22/2021
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