Organization Name: | CALLAHAN CLINIC, PC |
NPI Number: | 1609046853 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS DEE CALLAHAN (PRESIDENT) |
Mailing Address: | 1240 E 100 S Suite 15-a St George |
State: | UT US |
Postal Code: | 847903001 |
Phone Number: | 4356565323 |
Fax Number: | 4356565127 |
NPI Enumeration Date: | 03/04/2008 |
NPI Last Update Date: | 02/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 1594201205 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |