Healthcare Provider Details

I. General information

NPI: 1235392366
Provider Name (Legal Business Name): ROBERT JOHN CALLAHAN II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 RIVERBEND DR
SPRINGFIELD OR
97477-8800
US

IV. Provider business mailing address

840 BELTLINE RD STE 210
SPRINGFIELD OR
97477-1192
US

V. Phone/Fax

Practice location:
  • Phone: 541-222-6929
  • Fax:
Mailing address:
  • Phone: 541-344-8757
  • Fax: 541-683-2527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberR70582
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberMD154296
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD154296
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: