MEDICARE: MR. MATTHEW DAVID CAUDLE M.D.

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	207P00000X	Emergency Medicine Physician	11013210A	IN
2	207P00000X	Emergency Medicine Physician	26822	OK

General Provider Information

NPI Number	:	1649473166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW DAVID CAUDLE M.D.

Provider Business Mailing Address
First Line	:	14291 BEAVER CREEK RD
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73025-7709
Country	:	US
Telephone Number	:	405-951-2541
Fax Number	:	405-951-2237

Provider Business Practice Location Address
First Line	:	3300 NW EXPRESSWAY
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4418
Country	:	US
Telephone Number	:	405-951-2541
Fax Number	:	405-951-2237

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

Provider Enumeration Date	:	06/11/2007
Last Update Date	:	03/13/2026

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