Individual
MARTY CAUDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
404 DURLEY ST, GREENVILLE, IL 62246
(618) 690-3595
(618) 690-3596
Mailing address
404 DURLEY ST, GREENVILLE, IL 62246-1504
(186) 903-5956
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4854
TN
363A00000X
Physician Assistant
PA01451
OR
Other
Enumeration date
02/13/2009
Last updated
01/05/2024
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