Healthcare Provider Details

I. General information

NPI: 1871689356
Provider Name (Legal Business Name): CHADWICK T CAUDILL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1296 JEFFCO BLVD
ARNOLD MO
63010-2138
US

IV. Provider business mailing address

1296 JEFFCO BLVD
ARNOLD MO
63010-2138
US

V. Phone/Fax

Practice location:
  • Phone: 636-321-8600
  • Fax:
Mailing address:
  • Phone: 636-321-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number108544
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: