Healthcare Provider Details

I. General information

NPI: 1033104518
Provider Name (Legal Business Name): GEORGE FRANKLIN CALLOWAY II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 01/09/2020
Certification Date: 01/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 COOPER RD
WESTERVILLE OH
43081-8723
US

IV. Provider business mailing address

495 COOPER RD SUITE 415
WESTERVILLE OH
43081-8723
US

V. Phone/Fax

Practice location:
  • Phone: 614-891-7878
  • Fax: 614-891-6888
Mailing address:
  • Phone: 614-891-7878
  • Fax: 614-891-6888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number35038419C
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35038419
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: