Healthcare Provider Details

I. General information

NPI: 1487766002
Provider Name (Legal Business Name): DAVID WHITNEY CAULKINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 01/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 MEDICAL CENTER DR
FISHERSVILLE VA
22939-2332
US

IV. Provider business mailing address

PO BOX 388
FISHERSVILLE VA
22939-0388
US

V. Phone/Fax

Practice location:
  • Phone: 540-245-7230
  • Fax: 540-245-7235
Mailing address:
  • Phone: 540-245-7230
  • Fax: 540-245-7235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101037984
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: