Provider Demographics
NPI:1043500978
Name:TERRA C. CAUDILL, MD, MS, PLLC
Entity Type:Organization
Organization Name:TERRA C. CAUDILL, MD, MS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAUDILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-208-4800
Mailing Address - Street 1:24 2ND AVE NE STE 201
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-5045
Mailing Address - Country:US
Mailing Address - Phone:828-324-9900
Mailing Address - Fax:
Practice Address - Street 1:24 2ND AVE NE STE 201
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5045
Practice Address - Country:US
Practice Address - Phone:828-324-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-009732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty