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General NPI Number Information
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NPI Number | 1033320007
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Entity Type | Organization
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Legal Business Name | ROBERT L. CAULKINS, D.O.
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 2601 CHERRY AVE 208
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City | BREMERTON
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State | WA
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Zip | 98310-4203
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Country | US
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Telephone | 360-373-9191
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Fax | 360-373-8682
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Provider Business Mailing Address
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Address Line | 2601 CHERRY AVE 208
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City | BREMERTON
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State | WA
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Zip | 98310-4208
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Country | US
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Telephone | 360-373-9191
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Fax | 360-373-8682
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT LEE CAULKINS
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Credential | DO
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Telephone | 360-373-9191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | OA10000192
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP3004792
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OP00001096
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License Number State | WA
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