Provider Demographics
NPI:1265129928
Name:TEAGUE, CALEB WESLEY
Entity type:Individual
Prefix:
First Name:CALEB
Middle Name:WESLEY
Last Name:TEAGUE
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 1:1116 LILLY VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-2581
Mailing Address - Country:US
Mailing Address - Phone:512-815-0037
Mailing Address - Fax:
Practice Address - Street 1:1075 HENDERSONVILLE RD STE 100
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-7802
Practice Address - Country:US
Practice Address - Phone:828-820-8066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant