Provider Demographics
NPI:1003850280
Name:MCCAULEY, LOWELL L JR (MD)
Entity Type:Individual
Prefix:DR
First Name:LOWELL
Middle Name:L
Last Name:MCCAULEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LOWELL
Other - Middle Name:L
Other - Last Name:MCCAULEY
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6216 HIGHLAND PLACE WAY STE 102
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4068
Mailing Address - Country:US
Mailing Address - Phone:865-549-5151
Mailing Address - Fax:865-549-5147
Practice Address - Street 1:6216 HIGHLAND PLACE WAY STE 102
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4068
Practice Address - Country:US
Practice Address - Phone:865-549-5151
Practice Address - Fax:865-549-5147
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN019982174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNC19051Medicare UPIN
TN3731558Medicare ID - Type Unspecified