Individual
DR. TIMOTHY G CAUDILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 W POPLAR ST, WALLA WALLA, WA 99362-2846
(509) 529-1284
Mailing address
PO BOX 1663, WALLA WALLA, WA 99362-0031
(509) 529-1284
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD00032378
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050051134
RAILROAD MEDICARE
WA
05
—
075072
—
OR
05
—
8180499
—
WA
Enumeration date
06/16/2005
Last updated
01/21/2008
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