Healthcare Provider Details

I. General information

NPI: 1104083757
Provider Name (Legal Business Name): DR. PAUL HAYDEN CAUDILL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 08/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4220 HARDING PIKE EMERGENCY MEDICAL CONSULTANTS OF NASHVILLE
NASHVILLE TN
37205-2005
US

IV. Provider business mailing address

PO BOX 3490 EMERGENCY MEDICAL CONSULTANTS OF NASHVILLE
CLARKSVILLE TN
37043-3490
US

V. Phone/Fax

Practice location:
  • Phone: 615-222-6733
  • Fax: 931-647-5034
Mailing address:
  • Phone: 931-647-5034
  • Fax: 931-552-6663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number49702
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2010-01559
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: