Provider Demographics
NPI:1174507578
Name:CAUTHEN, WILLIAM LOUIS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LOUIS
Last Name:CAUTHEN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:947 S IRBY ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5238
Mailing Address - Country:US
Mailing Address - Phone:843-629-7074
Mailing Address - Fax:843-629-7274
Practice Address - Street 1:805 PAMPLICO HWY
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6047
Practice Address - Country:US
Practice Address - Phone:843-674-5143
Practice Address - Fax:843-674-5146
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2022-12-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2021034317207P00000X
KY57335207P00000X
SC12928207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC129284Medicaid
SC129284Medicaid
SCB91845Medicare UPIN