Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD017903 | TN |
Y | 208600000X | Surgeon | MD017903 | TN |
N | 208D00000X | General Practice Physician | MD017903 | TN |
NPI | 1023071651 |
---|---|
Provider Name | Dr. James A Caylor |
First Address | Dyersburg, TN 38024 |
Second Address | Dyersburg, TN 38024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 29/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
117023 | TENNCARE UNISOM (01) | TN |
3052319 | (05) | TN |
BC1704522 | BCBS OF TN (01) | TN |
E57539 | (02) | TN |