Healthcare Provider Details

I. General information

NPI: 1790122299
Provider Name (Legal Business Name): ANDREW N MCCALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2013
Last Update Date: 10/03/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8080 BLUEBONNET BLVD STE 3000
BATON ROUGE LA
70810-7829
US

IV. Provider business mailing address

8080 BLUEBONNET BLVD. SUITE 3000
BATON ROUGE LA
70810
US

V. Phone/Fax

Practice location:
  • Phone: 225-766-8100
  • Fax: 225-766-3240
Mailing address:
  • Phone: 225-766-8100
  • Fax: 225-766-3240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number58114
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: