MEDICARE: PERCY THOMAS CAUSEY JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	L020118	LA
2	207RC0000X	Cardiovascular Disease Physician	2022-01981	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477655876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PERCY THOMAS CAUSEY JR. MD

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:	336-481-8540
Fax Number	:	336-481-8549

Provider Business Practice Location Address
First Line	:	1226 EASTCHESTER DR STE 100
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-3116
Country	:	US
Telephone Number	:	336-481-8540
Fax Number	:	336-481-8549

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	09/16/2022

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