Provider Demographics
NPI:1922287713
Name:CAUGHEY, DALE W JR (MD)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:W
Last Name:CAUGHEY
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 4667
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28406-1667
Mailing Address - Country:US
Mailing Address - Phone:910-799-4220
Mailing Address - Fax:910-799-0460
Practice Address - Street 1:5305A WRIGHTSVILLE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6507
Practice Address - Country:US
Practice Address - Phone:910-799-4220
Practice Address - Fax:910-799-0460
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16842207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7557727OtherCIGNA
NC21738OtherBLUE CROSS
NC8921738Medicaid
NC589598OtherUNITED HEALTHCARE
NC7557727OtherCIGNA
NC589598OtherUNITED HEALTHCARE