Healthcare Provider Details
I. General information
NPI: 1356335145
Provider Name (Legal Business Name): JAMES MCCAULEY MD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/07/2005
Last Update Date: 10/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15260 NW 147TH DR SUITE 100
ALACHUA FL
32615-5309
US
IV. Provider business mailing address
15260 NW 147TH DR SUITE 100
ALACHUA FL
32615-5309
US
V. Phone/Fax
- Phone: 386-418-1222
- Fax: 386-418-0622
- Phone: 386-418-1222
- Fax: 386-418-0622
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | ME0075035 |
| License Number State | FL |
VIII. Authorized Official
Name:
MICHELLE
L
MCCAULEY
Title or Position: PRACTICE MANAGER
Credential:
Phone: 386-418-1222