Provider Demographics
NPI:1467796177
Name:CAULEY, WILLIAM JOSEPH JR
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:CAULEY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:BILL
Other - Middle Name:JOSEPH
Other - Last Name:CAULEY
Other - Suffix:V
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:11098 SAFFOLD WAY
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3816
Mailing Address - Country:US
Mailing Address - Phone:703-742-0201
Mailing Address - Fax:
Practice Address - Street 1:1109 SAFFOLD WAY
Practice Address - Street 2:US GOVERNMENT EMPLOYEE
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3816
Practice Address - Country:US
Practice Address - Phone:703-742-0201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA024135487363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0000000000OtherUS GOVERNMENT EMPLOYEE, NUMBERS NOT APPLICABLE