Provider Demographics
NPI:1649241878
Name:MCAULEY, ROBERT TOWERY (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:TOWERY
Last Name:MCAULEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 AZALEA DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-8100
Mailing Address - Country:US
Mailing Address - Phone:662-234-4744
Mailing Address - Fax:662-234-4749
Practice Address - Street 1:506 AZALEA DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-8100
Practice Address - Country:US
Practice Address - Phone:662-234-4744
Practice Address - Fax:662-234-4749
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS13900208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00119264Medicaid
MS020000322Medicare ID - Type Unspecified
MSG65647Medicare UPIN