Provider Demographics
NPI:1023052032
Name:CAUSO, RICARDO FEDERICO (MD)
Entity type:Individual
Prefix:MR
First Name:RICARDO
Middle Name:FEDERICO
Last Name:CAUSO
Suffix:
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 1:6025 LEE HWY
Mailing Address - Street 2:STE. 447
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3099
Mailing Address - Country:US
Mailing Address - Phone:423-490-1547
Mailing Address - Fax:423-490-1197
Practice Address - Street 1:6025 LEE HWY
Practice Address - Street 2:STE. 447
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3099
Practice Address - Country:US
Practice Address - Phone:423-490-1547
Practice Address - Fax:423-490-1197
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD19907208000000X
TN199072080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF19846Medicare UPIN