Provider Demographics
NPI:1487766002
Name:CAULKINS, DAVID WHITNEY (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WHITNEY
Last Name:CAULKINS
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:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0388
Mailing Address - Country:US
Mailing Address - Phone:540-245-7230
Mailing Address - Fax:540-245-7235
Practice Address - Street 1:78 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2332
Practice Address - Country:US
Practice Address - Phone:540-245-7230
Practice Address - Fax:540-245-7235
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101037984208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7304889Medicaid
VA020000967Medicare ID - Type Unspecified
VA7304889Medicaid
GC1100Medicare PIN