Healthcare Provider Details

I. General information

NPI: 1336564319
Provider Name (Legal Business Name): JOHN FELIX MCCAULEY IV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2014
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 OLD MEADOW RD STE 305
MC LEAN VA
22102-4330
US

IV. Provider business mailing address

9300 DEWITT LOOP FL 2
FORT BELVOIR VA
22060-5285
US

V. Phone/Fax

Practice location:
  • Phone: 703-717-4200
  • Fax: 703-717-4201
Mailing address:
  • Phone: 205-789-5368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number0101259041
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: