Organization
LESLIE CAUDILL PLLC
Active
Other names
23rd Avenue Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE CAUDILL (MD)
(270) 776-2328
Entity
Organization
Contact information
Practice address
204 23RD AVE N, NASHVILLE, TN 37203-1502
(615) 321-1010
Mailing address
9608 BOUCHAINE PASS, BRENTWOOD, TN 37027-3836
(270) 776-2328
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
49471
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326205824
INDIVIDUAL NPI
TN
Enumeration date
12/07/2015
Last updated
12/09/2015
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