Provider Demographics
NPI:1346519071
Name:CALDWELL, JAY E (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:E
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 65587
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85728-5587
Mailing Address - Country:US
Mailing Address - Phone:520-299-4572
Mailing Address - Fax:520-398-4375
Practice Address - Street 1:4700 N CAMINO CORTO
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-6011
Practice Address - Country:US
Practice Address - Phone:520-299-4572
Practice Address - Fax:520-398-4375
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1526207RA0401X
AZ331522081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine