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MATTHEW TOBIAS MCCAULEY CRNP
>> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1700151396
Individual Registrant: MATTHEW TOBIAS MCCAULEY CRNP
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
13624 COUNTY ROAD 8 WOODVILLE, AL 35776-6162 US
Tel: 256-776-5615 Fax: 256-776-5617
Tel: 256-776-5615 Fax: 256-776-5617
Contact information for business:
309 TAYLOR ST SCOTTSBORO, AL 35768-2421 US
Tel: 256-259-5313 Fax: 256-259-4923
Tel: 256-259-5313 Fax: 256-259-4923
Registration Information:
NPI: 1700151396
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | AL | 1-126825 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 142430 | AL | 05 | |
| 145163 | AL | 05 | |
| TRICARE | 1700151396 | AL | 01 |
| BC/BS OF ALABAMA | 51128618 | AL | 01 |
