Provider Demographics
NPI:1639115843
Name:CAULKINS, MARCY (DC)
Entity Type:Individual
Prefix:DR
First Name:MARCY
Middle Name:
Last Name:CAULKINS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 SAXTONS RIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:BELLOWS FALLS
Mailing Address - State:VT
Mailing Address - Zip Code:05101
Mailing Address - Country:US
Mailing Address - Phone:802-463-9522
Mailing Address - Fax:802-463-1957
Practice Address - Street 1:102 SAXTONS RIVER ROAD
Practice Address - Street 2:
Practice Address - City:BELLOWS FALLS
Practice Address - State:VT
Practice Address - Zip Code:05101
Practice Address - Country:US
Practice Address - Phone:802-463-9522
Practice Address - Fax:802-463-1957
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006-0001118111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009385Medicaid
VTVN3069Medicare ID - Type Unspecified
VT1009385Medicaid