Provider Demographics
NPI:1245377613
Name:CALDWELL, STEVEN L
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:L
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 E BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804-3202
Mailing Address - Country:US
Mailing Address - Phone:865-982-3020
Mailing Address - Fax:865-977-6698
Practice Address - Street 1:1536 E BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-3202
Practice Address - Country:US
Practice Address - Phone:865-982-3020
Practice Address - Fax:865-977-6698
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4991183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist