Healthcare Provider Details

I. General information

NPI: 1427171354
Provider Name (Legal Business Name): IFE J CAULEY RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1170 CLEVELAND AVE
EAST POINT GA
30344-3615
US

IV. Provider business mailing address

2645 PARKWAY TRL
LITHONIA GA
30058-4651
US

V. Phone/Fax

Practice location:
  • Phone: 404-466-1094
  • Fax:
Mailing address:
  • Phone: 678-620-1753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number5335
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License Number5335
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: