Provider Demographics
NPI:1790276699
Name:CALDWELL, TYLER (AUD)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 NICHOLASVILLE RD STE 500
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1487
Mailing Address - Country:US
Mailing Address - Phone:859-278-1114
Mailing Address - Fax:859-277-0541
Practice Address - Street 1:1720 NICHOLASVILLE RD STE 500
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1487
Practice Address - Country:US
Practice Address - Phone:859-278-1114
Practice Address - Fax:859-277-0541
Is Sole Proprietor?:No
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist