Provider Demographics
NPI:1063411817
Name:CALLAHAN, FLINTON II (MD)
Entity type:Individual
Prefix:DR
First Name:FLINTON
Middle Name:
Last Name:CALLAHAN
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DAVIS AVE SW
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-3824
Mailing Address - Country:US
Mailing Address - Phone:703-777-1244
Mailing Address - Fax:540-338-9137
Practice Address - Street 1:20 DAVIS AVE SW
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-3824
Practice Address - Country:US
Practice Address - Phone:703-777-1244
Practice Address - Fax:540-338-9137
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2009-03-19
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-30
Provider Licenses
StateLicense IDTaxonomies
VA0101021979207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB05018Medicare UPIN
VA180000171Medicare ID - Type Unspecified