Healthcare Provider Details

I. General information

NPI: 1477718013
Provider Name (Legal Business Name): GREGORY CAUDILL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2008
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
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: 336-926-1588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number206035
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number149560
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: