Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 1526 | AK |
N | 2081S0010X | Sports Medicine | 33152 | AZ |
N | 213ES0000X | Sports Medicine | 33152 | AZ |
NPI | 1346519071 |
---|---|
Provider Name | Dr. Jay E Caldwell |
First Address | Tucson, AZ 85728-5587 |
Second Address | Tucson, AZ 85718-6011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2011 |
Last Update Date | 27/12/2011 |