Healthcare Provider Details

I. General information

NPI: 1295896207
Provider Name (Legal Business Name): A N MCCALLUM MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 RIDGEWAY DR
LAFAYETTE LA
70503-3405
US

IV. Provider business mailing address

137 RIDGEWAY DR
LAFAYETTE LA
70503-3405
US

V. Phone/Fax

Practice location:
  • Phone: 337-981-5694
  • Fax: 337-981-5699
Mailing address:
  • Phone: 337-981-5694
  • Fax: 337-981-5699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ARTHUR NEWELL MCCALLUM
Title or Position: PRESIDENT
Credential: MD
Phone: 337-981-5694