Healthcare Provider Details

I. General information

NPI: 1972396919
Provider Name (Legal Business Name): CAITLIN TELFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PECAN ST SE
WASHINGTON DC
20032-2652
US

IV. Provider business mailing address

3811 FAIRFAX DR STE 1000
ARLINGTON VA
22203-1782
US

V. Phone/Fax

Practice location:
  • Phone: 771-444-6200
  • Fax:
Mailing address:
  • Phone: 202-741-3570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberPA200002289
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: