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NPI Code Detail

MEDICARE: DR. TATJANA CADDELL MD

MEDICARE:  DR. TATJANA  CADDELL  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician4824MT

General Provider Information

NPI Number : 1457458770
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TATJANA CADDELL MD
Provider Business Mailing Address
First Line : 1MAIN ST
Second Line :
City : WARM SPRINGS
State : MT
Zip : 59756
Country : US
Telephone Number : 406-693-7142
Fax Number : 406-693-7069
Provider Business Practice Location Address
First Line : 1MAIN ST
Second Line :
City : WARM SPRINGS
State : MT
Zip : 59756
Country : US
Telephone Number : 406-693-7142
Fax Number : 406-693-7069
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 07/09/2007

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Directions to “ DR. TATJANA CADDELL MD” Practice Location

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