Provider Demographics
NPI:1215905401
Name:CALICA, ARNOLD BARRY (MD)
Entity type:Individual
Prefix:
First Name:ARNOLD
Middle Name:BARRY
Last Name:CALICA
Suffix:
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 1:525 N 18TH ST STE 407
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-3746
Mailing Address - Country:US
Mailing Address - Phone:602-253-5453
Mailing Address - Fax:602-253-5997
Practice Address - Street 1:525 N 18TH ST STE 407
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-3746
Practice Address - Country:US
Practice Address - Phone:602-253-5453
Practice Address - Fax:602-253-5997
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12548207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ278764Medicaid
AZZ29064Medicare ID - Type Unspecified
ARD36631Medicare UPIN
AZ278764Medicaid