Healthcare Provider Details

I. General information

NPI: 1346144789
Provider Name (Legal Business Name): CONNOR CALLAHAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 23RD AVE
MERIDIAN MS
39301-4027
US

IV. Provider business mailing address

1501 23RD AVE
MERIDIAN MS
39301-4027
US

V. Phone/Fax

Practice location:
  • Phone: 601-696-8082
  • Fax: 877-229-1725
Mailing address:
  • Phone: 601-696-8082
  • Fax: 877-229-1725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberE-102553
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: