Caudell, Misty Dawn
Caudell, Misty Dawn is an individual health care provider with primary practice located at 1498 Jesse Jewell Pkwy Se Ste D , Gainesville GA 30501-3874. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Caudell, Misty Dawn can be contacted via phone (770) 535-7546.Contact Information
Primary practice address
1498 Jesse Jewell Pkwy Se Ste D
Gainesville GA 30501-3874
Phone: (770) 535-7546
Fax: (770) 535-7591
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | MD425726 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 15031 | Nevada |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 058402 | Georgia |
Profile Details
| NPI number | 1821060781 |
|---|---|
| LBN Legal business name | Caudell, Misty Dawn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2006 |
| Last updated | Jan 2nd, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821060781 | NPPES |
| Pennsylvania | MEDICAID | 101343342 |
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