Provider Demographics
NPI:1023071651
Name:CAYLOR, JAMES A (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:CAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:O
Other - Middle Name:FRED
Other - Last Name:MOORE
Other - Suffix:III
Other - Last Name Type:Other Name
Other - Credentials:MD PC
Mailing Address - Street 1:503 TICKLE STREET
Mailing Address - Street 2:SUITE #1
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024
Mailing Address - Country:US
Mailing Address - Phone:731-285-5244
Mailing Address - Fax:731-285-8970
Practice Address - Street 1:503 TICKLE STREET
Practice Address - Street 2:SUITE #1
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024
Practice Address - Country:US
Practice Address - Phone:731-285-5244
Practice Address - Fax:731-285-8970
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD017903208600000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN117023OtherTENNCARE UNISOM
TN3052319Medicaid
TNBC1704522OtherBCBS OF TN
TNE57539Medicare UPIN
TN3052319Medicaid