Provider Demographics
NPI:1477655876
Name:CAUSEY, PERCY THOMAS JR (MD)
Entity Type:Individual
Prefix:
First Name:PERCY
Middle Name:THOMAS
Last Name:CAUSEY
Suffix:JR
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 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:336-481-8540
Mailing Address - Fax:336-481-8549
Practice Address - Street 1:1226 EASTCHESTER DR STE 100
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3116
Practice Address - Country:US
Practice Address - Phone:336-481-8540
Practice Address - Fax:336-481-8549
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL020118207RC0000X
NC2022-01981207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1674516Medicaid
LA1674516Medicaid
LA4A393CX63Medicare PIN