Healthcare Provider Details

I. General information

NPI: 1053245480
Provider Name (Legal Business Name): GREGORY B CAUDILL MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2372 SAINT CLAUDE AVE STE 220
NEW ORLEANS LA
70117-8388
US

IV. Provider business mailing address

725 BARTHOLOMEW ST
NEW ORLEANS LA
70117-5413
US

V. Phone/Fax

Practice location:
  • Phone: 504-399-4880
  • Fax:
Mailing address:
  • Phone: 504-399-4880
  • Fax: 504-608-7069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: AMANDA CAUDILL
Title or Position: ADMINISTRATOR
Credential:
Phone: 985-412-0386