Provider Demographics
NPI:1356346381
Name:CAUGHLIN, CHARLES ANDREW (DC)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ANDREW
Last Name:CAUGHLIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 NW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:JOHN DAY
Mailing Address - State:OR
Mailing Address - Zip Code:97845-1101
Mailing Address - Country:US
Mailing Address - Phone:541-575-1063
Mailing Address - Fax:541-575-5554
Practice Address - Street 1:155 NW 1ST AVE
Practice Address - Street 2:
Practice Address - City:JOHN DAY
Practice Address - State:OR
Practice Address - Zip Code:97845-1101
Practice Address - Country:US
Practice Address - Phone:541-575-1063
Practice Address - Fax:541-575-5554
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27-2692111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP00178054OtherRAILROAD MEDICARE PIN
OR0000QGFQZMedicare PIN