Individual
DR. SCOTT O CAUDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1503 W ELK AVE, SUITE 1, ELIZABETHTON, TN 37643-2876
(423) 543-8619
(423) 543-5133
Mailing address
1503 W ELK AVE, SUITE 1, ELIZABETHTON, TN 37643-2876
(423) 543-8619
(423) 543-5133
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MA13233
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3380824
—
TN
01
—
39248
BLUE CROSS BLUE SHIELD
TN
Enumeration date
10/04/2005
Last updated
11/09/2010
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