Provider Demographics
NPI:1063421261
Name:MICHAEL A CALLAHAN MD & ASSOC PC
Entity type:Organization
Organization Name:MICHAEL A CALLAHAN MD & ASSOC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:HUNTER
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-558-4344
Mailing Address - Street 1:700 18TH ST S
Mailing Address - Street 2:SUITE 711
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-3806
Mailing Address - Country:US
Mailing Address - Phone:205-933-6888
Mailing Address - Fax:205-933-6421
Practice Address - Street 1:700 18TH ST S
Practice Address - Street 2:SUITE 711
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-3806
Practice Address - Country:US
Practice Address - Phone:205-933-6888
Practice Address - Fax:205-933-6421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51523638OtherBCBS
AL1902892151Medicare NSC
AL1780751040Medicare NSC
U06204Medicare UPIN
AL1760478226Medicare NSC
0766130001Medicare NSC
AL51523638OtherBCBS
C75132Medicare UPIN
AL1033105283Medicare NSC
E376Medicare PIN