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General NPI Number Information
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NPI Number | 1942863022
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Entity Type | Individual
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Provider Name | MATTHEW JOSEPH CALHOUN MD
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Gender | Male
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Dates
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Enumeration Date | 04/15/2019
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 17040 N 51ST AVE STE 100
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City | GLENDALE
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State | AZ
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Zip | 85308-1496
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Country | US
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Telephone | 602-406-1164
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Fax | 623-935-9495
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Provider Business Mailing Address
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Address Line | 2946 E BANNER GATEWAY DR
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City | GILBERT
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State | AZ
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Zip | 85234-2165
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Country | US
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Telephone |
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Fax |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 61530
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME169624
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 61530
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License Number State | AZ
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