Provider Demographics
NPI:1104083757
Name:CAUDILL, PAUL HAYDEN
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:HAYDEN
Last Name:CAUDILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3490
Mailing Address - Street 2:EMERGENCY MEDICAL CONSULTANTS OF NASHVILLE
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-3490
Mailing Address - Country:US
Mailing Address - Phone:931-647-5034
Mailing Address - Fax:931-552-6663
Practice Address - Street 1:4220 HARDING PIKE
Practice Address - Street 2:EMERGENCY MEDICAL CONSULTANTS OF NASHVILLE
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2005
Practice Address - Country:US
Practice Address - Phone:615-222-6733
Practice Address - Fax:931-647-5034
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN49702207P00000X
NC2010-01559207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC159WUOtherBCBSNC
NC5915700Medicaid
NCP01084145OtherRAILROAD MEDICARE
TN10393I9658Medicare PIN
NCP01084145OtherRAILROAD MEDICARE