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General NPI Number Information
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NPI Number | 1164694089
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Entity Type | Individual
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Provider Name | KEISHA RENEE CALLINS M.D., M.P.H.
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Gender | Female
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Dates
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Enumeration Date | 03/31/2008
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Last Update Date | 10/31/2017
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Provider Practice Location Address
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Address Line | 1550 COLLEGE ST
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City | MACON
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State | GA
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Zip | 31207-1500
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Country | US
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Telephone | 478-301-2696
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Fax | 478-301-2116
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Provider Business Mailing Address
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Address Line | 4292 GRAY HWY
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City | GRAY
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State | GA
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Zip | 31032-5900
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Country | US
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Telephone | 478-301-2362
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Fax | 478-301-2272
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 879908
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 065643
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License Number State | GA
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