MEDICARE: ANTHONY JEROME CAWTHON DPM

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
1	213E00000X	Podiatrist	529	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568464519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY JEROME CAWTHON DPM

Provider Business Mailing Address
First Line	:	2033 GREYSTONE PARK
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-3576
Country	:	US
Telephone Number	:	731-660-3664
Fax Number	:	731-660-3620

Provider Business Practice Location Address
First Line	:	2033 GREYSTONE PARK
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-3576
Country	:	US
Telephone Number	:	731-660-3664
Fax Number	:	731-660-3620

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	04/29/2025

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