Individual
DR. MISTY DAWN CAUDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1498 JESSE JEWELL PKWY SE STE D, GAINESVILLE, GA 30501-3874
(770) 535-7546
(770) 535-7591
Mailing address
PO BOX 1456, GAINESVILLE, GA 30503-1456
(770) 535-7546
(770) 535-7591
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD425726
PA
207N00000X
Dermatology Physician
Primary
058402
GA
207N00000X
Dermatology Physician
15031
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101343342
—
PA
Enumeration date
02/06/2006
Last updated
01/02/2023
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