Healthcare Provider Details

I. General information

NPI: 1265503197
Provider Name (Legal Business Name): ROBERT JASON CAUGHEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3341 BEALE AVE
ALTOONA PA
16601-1549
US

IV. Provider business mailing address

3341 BEALE AVE
ALTOONA PA
16601-1549
US

V. Phone/Fax

Practice location:
  • Phone: 814-944-5357
  • Fax: 814-946-8017
Mailing address:
  • Phone: 814-944-5357
  • Fax: 814-946-8017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberMD430275
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD430275
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: