Provider Demographics
NPI:1831786888
Name:CALDWELL, CHRISTOPHER LOUIS JR (NP)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:LOUIS
Last Name:CALDWELL
Suffix:JR
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2951 SATELLITE BLVD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-2328
Mailing Address - Country:US
Mailing Address - Phone:404-609-1500
Mailing Address - Fax:
Practice Address - Street 1:2951 SATELLITE BLVD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-2328
Practice Address - Country:US
Practice Address - Phone:318-471-3278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA298887363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner