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NPI Code Detail

MEDICARE: DR. DANIEL JOSEPH CALLAN DO/MPH

MEDICARE: DR. DANIEL JOSEPH CALLAN DO/MPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician1905TN

General Provider Information

NPI Number : 1578560512
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL JOSEPH CALLAN DO/MPH
Provider Business Mailing Address
First Line : 3303 FERN VALLEY RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40213-3529
Country : US
Telephone Number : 502-403-5671
Fax Number :
Provider Business Practice Location Address
First Line : 3303 FERN VALLEY RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40213-3529
Country : US
Telephone Number : 502-403-5671
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2005
Last Update Date : 10/02/2014

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Directions to “ DR. DANIEL JOSEPH CALLAN DO/MPH” Practice Location

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