Provider Demographics
NPI:1396785929
Name:CALDWELL, ELIZABETH D (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:D
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 MCFARLAND CIR N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-1800
Mailing Address - Country:US
Mailing Address - Phone:205-345-7000
Mailing Address - Fax:205-343-0910
Practice Address - Street 1:208 MCFARLAND CIR N
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-1800
Practice Address - Country:US
Practice Address - Phone:205-345-7000
Practice Address - Fax:205-343-0910
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL187612085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009988700Medicaid
AL009989100Medicaid
AL000036420Medicaid
AL009989080Medicaid
AL009989110Medicaid
AL009989070Medicaid
AL009989090Medicaid
AL009988710Medicaid
AL009989040Medicaid
AL009989060Medicaid
AL009992390Medicaid
AL009988680Medicaid
AL009988690Medicaid
AL009989050Medicaid
AL009989060Medicaid
AL009988700Medicaid
AL009989080Medicaid