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Individual

MATTHEW TOBIAS MCCAULEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
13624 COUNTY ROAD 8, WOODVILLE, AL 35776-6162
(256) 776-5615
(256) 776-5617
Mailing address
309 TAYLOR ST, SCOTTSBORO, AL 35768-2421
(256) 259-5313
(256) 259-4923

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-126825
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
142430
AL
05
145163
AL
01
1700151396
TRICARE
AL
01
51128618
BC/BS OF ALABAMA
AL
Enumeration date
03/14/2012
Last updated
10/03/2013
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