Provider Demographics
NPI:1588198949
Name:VASS, CALEB (DO)
Entity Type:Individual
Prefix:DR
First Name:CALEB
Middle Name:
Last Name:VASS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2000 HEALTH PARK DR FL HP2
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4525
Mailing Address - Country:US
Mailing Address - Phone:615-372-7600
Mailing Address - Fax:
Practice Address - Street 1:4550 LEE HWY STE B
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:VA
Practice Address - Zip Code:24084-3802
Practice Address - Country:US
Practice Address - Phone:540-674-4560
Practice Address - Fax:540-674-4713
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102206156207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA540889154OtherEIN