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General NPI Number Information
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NPI Number | 1457875106
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Entity Type | Individual
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Provider Name | EARL THOMAS CAGE I ETC.
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Gender | Male
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Dates
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Enumeration Date | 08/02/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 646 N MAIN ST
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City | HALIFAX
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State | VA
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Zip | 24558-3248
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Country | US
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Telephone | 434-579-6950
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Fax | 434-476-7782
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Provider Business Mailing Address
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Address Line | 646 N MAIN ST
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City | HALIFAX
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State | VA
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Zip | 24558-3248
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Country | US
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Telephone | 434-579-6950
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Fax | 434-476-7782
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number |
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License Number State | VA
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