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General NPI Number Information
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NPI Number | 1356882369
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Entity Type | Organization
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Legal Business Name | JIM MCCAULEY MD PC
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Dates
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Enumeration Date | 03/10/2017
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Last Update Date | 03/10/2017
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Provider Practice Location Address
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Address Line | 427 TANAGER DR
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City | REDMOND
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State | OR
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Zip | 97756-8389
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Country | US
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Telephone | 541-420-9482
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Fax | 541-323-3794
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Provider Business Mailing Address
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Address Line | 427 TANAGER DR
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City | REDMOND
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State | OR
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Zip | 97756-8389
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Country | US
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Telephone | 541-420-9482
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Fax | 541-323-3794
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Authorized Official
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Title or Position | OWNER
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Name | DR. JIM MCCAULEY
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Credential | MD
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Telephone | 731-571-3491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD20134
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License Number State | OR
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