Provider Demographics
NPI:1063075315
Name:CALLAWAY, ALDEN FOSTER (NP)
Entity type:Individual
Prefix:MRS
First Name:ALDEN
Middle Name:FOSTER
Last Name:CALLAWAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 370
Mailing Address - Street 2:
Mailing Address - City:FORTSON
Mailing Address - State:GA
Mailing Address - Zip Code:31808-0370
Mailing Address - Country:US
Mailing Address - Phone:706-494-3071
Mailing Address - Fax:706-494-3201
Practice Address - Street 1:100 N MACON ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-6563
Practice Address - Country:US
Practice Address - Phone:478-200-6970
Practice Address - Fax:478-216-5976
Is Sole Proprietor?:No
Enumeration Date:2019-04-22
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN248428363L00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse