Healthcare Provider Details

I. General information

NPI: 1386716132
Provider Name (Legal Business Name): TIFFANY N SAULS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 03/10/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 CANTER FIELD LN
CANDLER NC
28715-7134
US

IV. Provider business mailing address

70 CANTER FIELD LN
CANDLER NC
28715-7134
US

V. Phone/Fax

Practice location:
  • Phone: 828-620-1695
  • Fax:
Mailing address:
  • Phone: 828-620-1695
  • Fax: 888-600-2975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number2012-02423
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2012-02423
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: