Caudill-Deaton, Tara J

Caudill-Deaton, Tara J is an individual health care provider with primary practice located at 1200 W 12 Mile Rd , Madison Heights MI 48071-4439. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Caudill-Deaton, Tara J can be contacted via phone (248) 543-0600.

Contact Information

Primary practice address
1200 W 12 Mile Rd Madison Heights MI 48071-4439
Phone: (248) 543-0600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301080294 Michigan

Profile Details

NPI number 1154380129
LBN Legal business name Caudill-Deaton, Tara J
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2006
Last updated Mar 6th, 2008 - about 16 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154380129 NPPES
Michigan Other 080F370780 BCBSM
Michigan MEDICAID 4815480 BCBSM

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