Basic Information
| Provider Information | |||||||||
| NPI: | 1104083757 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAUDILL | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | HAYDEN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3490 | ||||||||
| Address2: | EMERGENCY MEDICAL CONSULTANTS OF NASHVILLE | ||||||||
| City: | CLARKSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370433490 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9316475034 | ||||||||
| FaxNumber: | 9315526663 | ||||||||
| Practice Location | |||||||||
| Address1: | 4220 HARDING PIKE | ||||||||
| Address2: | EMERGENCY MEDICAL CONSULTANTS OF NASHVILLE | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372052005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152226733 | ||||||||
| FaxNumber: | 9316475034 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2008 | ||||||||
| LastUpdateDate: | 08/27/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 49702 | TN | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 2010-01559 | NC | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 159WU | 01 | NC | BCBSNC | OTHER | 5915700 | 05 | NC | MEDICAID | P01084145 | 01 | NC | RAILROAD MEDICARE | OTHER |