Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD430275 | PA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | MD430275 | PA |
NPI | 1265503197 |
---|---|
Provider Name | Robert Jason Caughey |
First Address | Altoona, PA 16601-1549 |
Second Address | Altoona, PA 16601-1549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 27/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1019045700001 | (05) | PA |
CA1956813 | BLUE SHIELD (01) | |
MD430275 | STATE LICENSE (01) | PA |
P00400431 | MEDICARE RAILROAD (01) | PA |