Healthcare Provider Details

I. General information

NPI: 1013989995
Provider Name (Legal Business Name): BARRY S CALLAHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 PAUL W BRYANT DR E
TUSCALOOSA AL
35401-2055
US

IV. Provider business mailing address

PO BOX 2447
TUSCALOOSA AL
35403-2447
US

V. Phone/Fax

Practice location:
  • Phone: 205-345-0192
  • Fax: 205-464-4507
Mailing address:
  • Phone: 205-345-0192
  • Fax: 205-464-4507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number33914
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberME102420
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number33914
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number19772
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: