Provider Demographics
NPI:1356335145
Name:JAMES MCCAULEY MD PA
Entity type:Organization
Organization Name:JAMES MCCAULEY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCCAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-418-1222
Mailing Address - Street 1:15260 NW 147TH DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-5309
Mailing Address - Country:US
Mailing Address - Phone:386-418-1222
Mailing Address - Fax:386-418-0622
Practice Address - Street 1:15260 NW 147TH DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ALACHUA
Practice Address - State:FL
Practice Address - Zip Code:32615-5309
Practice Address - Country:US
Practice Address - Phone:386-418-1222
Practice Address - Fax:386-418-0622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0075035207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264176300Medicaid
FLK3340Medicare ID - Type Unspecified