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General NPI Number Information
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NPI Number | 1396830543
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Entity Type | Organization
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Legal Business Name | CHADWICK T CAUDILL MD PS
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/25/2008
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Provider Practice Location Address
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Address Line | 10004 KENNERLY RD SUITE 350A
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2141
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Country | US
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Telephone | 314-543-5980
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Fax |
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Provider Business Mailing Address
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Address Line | 10004 KENNERLY RD SUITE 350A
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2141
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Country | US
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Telephone | 314-543-5980
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHADWICK T CAUDILL
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Credential | M.D.
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Telephone | 314-543-5980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 108544
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License Number State | MO
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