Healthcare Provider Details
I. General information
NPI: 1699608398
Provider Name (Legal Business Name): ROBERT CAULTON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3330 WOODBURN AVE APT 203
CINCINNATI OH
45207-0071
US
IV. Provider business mailing address
3330 WOODBURN AVE APT 203
CINCINNATI OH
45207-0071
US
V. Phone/Fax
- Phone: 513-407-1027
- Fax:
- Phone: 513-407-1027
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | PRS.007921 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: