Healthcare Provider Details

I. General information

NPI: 1982656567
Provider Name (Legal Business Name): RONALD DAVID CALDWELL JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 09/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 18TH ST SE
HICKORY NC
28602-1364
US

IV. Provider business mailing address

225 18TH ST SE
HICKORY NC
28602-1364
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-9912
  • Fax: 828-322-4078
Mailing address:
  • Phone: 828-322-9912
  • Fax: 828-322-4078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number2006-00302
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: