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General NPI Number Information
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NPI Number | 1245635929
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Entity Type | Individual
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Provider Name | CALLAWAY ANDERSON SKINNER PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/24/2014
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Last Update Date | 12/30/2021
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Provider Practice Location Address
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Address Line | 120 S ZETTEROWER AVE
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City | STATESBORO
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State | GA
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Zip | 30458-4816
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Country | US
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Telephone | 912-681-7368
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Fax | 912-681-3687
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Provider Business Mailing Address
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Address Line | 120 S ZETTEROWER AVE
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City | STATESBORO
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State | GA
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Zip | 30458-4816
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Country | US
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Telephone | 912-681-7368
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Fax | 912-681-3687
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 7433
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License Number State | GA
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