Provider Demographics
NPI:1871647248
Name:MCCAULEY, NANCY FAYE (DO)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:FAYE
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:FAYE
Other - Last Name:FERENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2424 N WYATT DR STE 260
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6118
Mailing Address - Country:US
Mailing Address - Phone:520-795-0608
Mailing Address - Fax:520-795-0354
Practice Address - Street 1:5111 N SCOTTSDALE RD STE 280
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-7091
Practice Address - Country:US
Practice Address - Phone:480-945-6583
Practice Address - Fax:480-423-6829
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4582207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ195018Medicaid
AZ116856Medicare Oscar/Certification
AZ116856Medicare UPIN
AZ195018Medicaid