BRENT K. CAUDILL (NPI# 1023083722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023083722 |
| Entity Type | Individual |
| Full Name | BRENT K. CAUDILL |
| Credential | MD |
| Practice Address |
Hwy 72 N Salem MO 65560 |
| Mailing Address |
Hwy 72 N Po Box 774 Salem MO 65560 |
| Practice Telephone | 5737296626 |
| Practice Fax Number | 5737296502 |
| Mailing Telephone | 5737296626 |
| Mailing Fax Number | 5737296502 |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2011-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 109789 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
HWY 72 N |
| City | SALEM |
| State | MO |
| Zip Code | 65560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174087985 | Brenda Gott | Nurse Practitioner | 3103 Hh Highway, Salem, MO 65560 | 2019-01-25 |
| 1174959142 | Britney Nicole Christesen | Chiropractor | 909 S Pershing Ave, Salem, MO 65560 | 2013-09-22 |
| 1245550474 | Amber Nicole Duncan | Chiropractor | 803 W 32 Hwy, Suite B, Salem, MO 65560 | 2010-06-10 |
| 1043460371 | Tina Marie Mcmullin | Counselor | 601 East Center Street, Salem, MO 65560 | 2008-09-23 |
| 1225286347 | Craig Tatom | Nurse Practitioner | Hwy 72 N Physicians Office Building II, Salem, MO 65560 | 2008-09-03 |
| 1114190576 | Jamie Johnston Wilson | Registered Nurse | Hwy 72 West, Salem, MO 65560 | 2008-04-08 |
| 1750589024 | Vicky L Gulley | Emergency Medicine | 35629 Hwy 72, Pob 1, Suite 3, Salem, MO 65560 | 2007-07-06 |
| 1275669533 | Complete Care, Inc | Durable Medical Equipment & Medical Supplies | 116 W. 4th, Salem, MO 65560 | 2007-02-23 |
| 1750369369 | Charles W Cunningham | Family Medicine | 1010 E Scenic Rivers Blvd, Salem, MO 65560 | 2006-01-04 |
| 1053396952 | H.e. Moser Corporation | Pharmacy | 900 S Main, Salem, MO 65560 | 2005-12-13 |
| Find all providers in zip 65560 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821342429 | Stephanie Nicole Reedy | General Practice | 2515 Liberty St Ne, Salem, OR 97301-8386 | 2012-11-04 |
| 1427207265 | John M Vargo | General Practice | 4305 Camas Ct Ne, Salem, OR 97305-2207 | 2008-09-17 |
| 1275797417 | Lagrand Johnson | General Practice | 326 Highway 6, Salem, UT 84653-5620 | 2008-07-16 |
| 1235392242 | John Mark Pozar | General Practice | 998 Capitol St Ne, Salem, OR 97301-1201 | 2008-07-09 |
| 1912175035 | Salem Clinic, PC | General Practice | 2531 Boone Road Se, Salem, OR 97306 | 2008-02-11 |
| 1104028364 | Ivan Dassenko | General Practice | 6810 Canyon St Se, Salem, OR 97317-9024 | 2007-06-01 |
| 1073668935 | Terence H Young | General Practice | 1205 Wallace Rd Nw, Salem, OR 97304-3007 | 2007-01-23 |
| 1639243348 | Thomas R Howard | General Practice | 567 Salem Quinton Rd, Ste C, Salem, NJ 08079-1255 | 2006-11-17 |
| 1316456965 | Anton Dubrick Md Sc | General Practice | 420 W Schwartz St, Salem, IL 62881-1552 | 2017-09-27 |
| 1174075154 | Kaiser Foundation Health Plan of The Northwest | General Practice | 5125 Skyline Rd S, Salem, OR 97306-9427 | 2016-10-26 |
| Find all providers in SALEM | ||||
Please comment or provide details below to improve the information on BRENT K. CAUDILL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.