Doctor Name: | JAMES M O'CALLAGHAN |
NPI Number: | 1548408347 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | PA2356 |
Business Practice Address: | 2188 Autumn Cove Cir Fleming Island, FL - 320033229 |
Business Phone Number: | 9046130991 |
Business Fax Number: | |
Mailing Address: | 2188 Autumn Cove Cir, FLEMING ISLAND |
State: | FL |
Postal Code: | 320033229 |
Phone Number: | 9046130991 |
Fax Number: | |
NPI Enumeration Date: | 02/02/2009 |
NPI Last Update Date: | 04/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA2356 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |