Healthcare Provider Details

I. General information

NPI: 1023052032
Provider Name (Legal Business Name): RICARDO FEDERICO CAUSO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 05/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6025 LEE HWY STE. 447
CHATTANOOGA TN
37421-3099
US

IV. Provider business mailing address

6025 LEE HWY STE. 447
CHATTANOOGA TN
37421-3099
US

V. Phone/Fax

Practice location:
  • Phone: 423-490-1547
  • Fax: 423-490-1197
Mailing address:
  • Phone: 423-490-1547
  • Fax: 423-490-1197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD19907
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number19907
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: