Provider Demographics
NPI:1538279690
Name:CAUTHEN, JOSEPH CLAUD III (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:CLAUD
Last Name:CAUTHEN
Suffix:III
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 1:6510 NW 9TH BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605
Mailing Address - Country:US
Mailing Address - Phone:352-331-0811
Mailing Address - Fax:352-332-6387
Practice Address - Street 1:6510 NW 9TH BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605
Practice Address - Country:US
Practice Address - Phone:352-331-0811
Practice Address - Fax:352-332-6387
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 0012242207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL215657OtherAVMED
FL01850WMedicare PIN
FL215657OtherAVMED
P00433245Medicare PIN
D50232Medicare UPIN