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NPI Code Detail

MEDICARE: CALEB SCHEDULE DO

MEDICARE:   CALEB  SCHEDULE  DO
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
1390200000XStudent in an Organized Health Care Education/Training Program37061MS
2207Q00000XFamily Medicine PhysicianE-20302AR

General Provider Information

NPI Number : 1588410914
Entity Type Code : Individual
Provider Name (Legal Business Name) : CALEB SCHEDULE DO
Provider Business Mailing Address
First Line : 905C S FRONTAGE RD
Second Line :
City : MERIDIAN
State : MS
Zip : 39301-6113
Country : US
Telephone Number : 601-482-4955
Fax Number :
Provider Business Practice Location Address
First Line : 905C S FRONTAGE RD
Second Line :
City : MERIDIAN
State : MS
Zip : 39301-6113
Country : US
Telephone Number : 601-482-4955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2024
Last Update Date : 05/14/2026

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Directions to “ CALEB SCHEDULE DO” Practice Location

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