Dustin Caudill, PA
Physician Assistant in Middleburg, FL. Individual provider (NPI-1).
NPI number1982103396
StatusActive
Last updated in NPPESFeb 21, 2023
Details
- NPI
- 1982103396
- Entity type
- Individual (NPI-1)
- Name
- Dustin Caudill
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 12, 2018
- Certification date
- Feb 21, 2023
- Last updated
- Feb 21, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA9113302 | FL | Yes |
| 363A00000X | Physician Assistant | 55108 | CA |
Practice location
1708 Blanding BlvdMiddleburg, FL 32068-3836
Phone 574-551-5160
Mailing address
705 Cypress Crossing TrlSaint Augustine, FL 32095-6808
Phone 574-551-5160
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