Basic Information
| Provider Information | |||||||||
| NPI: | 1356399885 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CALDWELL | ||||||||
| FirstName: | CRAIG | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5151 REED RD | ||||||||
| Address2: | SUITE 225-C | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432202595 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144572306 | ||||||||
| FaxNumber: | 6148840776 | ||||||||
| Practice Location | |||||||||
| Address1: | 5151 REED RD | ||||||||
| Address2: | SUITE 225-C | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432202595 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144572306 | ||||||||
| FaxNumber: | 6148840776 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2006 | ||||||||
| LastUpdateDate: | 05/18/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 35051781C | OH | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 0600237 | 05 | OH | MEDICAID | 050021838 | 01 | OH | MEDICARE RAILROAD | OTHER |