Basic Information
| Provider Information | |||||||||
| NPI: | 1679687784 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CALDWELL | ||||||||
| FirstName: | SHARON | ||||||||
| MiddleName: | MOORE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1113 MURFREESBORO RD | ||||||||
| Address2: | SUITE 319 | ||||||||
| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370641306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157900567 | ||||||||
| FaxNumber: | 6155958030 | ||||||||
| Practice Location | |||||||||
| Address1: | 1113 MURFREESBORO RD | ||||||||
| Address2: | SUITE 319 | ||||||||
| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370641306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157900567 | ||||||||
| FaxNumber: | 6155958030 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2006 | ||||||||
| LastUpdateDate: | 11/15/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 23669 | TN | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 5183054 | 01 | TN | AETNA | OTHER | 4015689 | 01 | TN | TENNCARE SELECT | OTHER | 4015689 | 01 | TN | BLUE CROSS BLUE SHIELD | OTHER | 1240277 | 01 | TN | UNITED HEALTHCARE | OTHER | 3099003 | 05 | TN | MEDICAID | 8552466 | 01 | TN | CIGNA | OTHER | 23669 | 01 | TN | MEDICAL LICENSE # | OTHER |