MEDICARE: ALFRED SAMUEL CALLAHAN III MD

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
1	2084N0400X	Neurology Physician	MD009933	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	7024	OTHER	KY	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	64772494	OTHER	KY	UNISYS

General Provider Information

NPI Number	:	1649206715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALFRED SAMUEL CALLAHAN III MD

Provider Business Mailing Address
First Line	:	2000 GLEN ECHO RD
Second Line	:	STE 122
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2857
Country	:	US
Telephone Number	:	615-297-5300
Fax Number	:	615-297-5301

Provider Business Practice Location Address
First Line	:	2000 GLEN ECHO RD
Second Line	:	STE 122
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2857
Country	:	US
Telephone Number	:	615-297-5300
Fax Number	:	615-297-5301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	02/20/2008

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