MEDICARE: CAYLIE PETERS

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	207Q00000X	Family Medicine Physician	88985	GA

General Provider Information

NPI Number	:	1871098400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAYLIE PETERS

Provider Business Mailing Address
First Line	:	6984 NASHVILLE ST
Second Line	:
City	:	RINGGOLD
State	:	GA
Zip	:	30736-2420
Country	:	US
Telephone Number	:	423-778-8682
Fax Number	:	423-778-8683

Provider Business Practice Location Address
First Line	:	6984 NASHVILLE ST
Second Line	:
City	:	RINGGOLD
State	:	GA
Zip	:	30736-2420
Country	:	US
Telephone Number	:	423-778-8682
Fax Number	:	423-778-8683

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

Provider Enumeration Date	:	03/26/2018
Last Update Date	:	03/10/2025

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Directions to “ CAYLIE PETERS ” Practice Location

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