Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | MD53546 | TN |
NPI | 1336330596 |
---|---|
Provider Name | Dr. Matthew John Caffrey |
First Address | Johnson City, TN 37601-3525 |
Second Address | Johnson City, TN 37601-3525 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2007 |
Last Update Date | 21/03/2019 |