Provider Demographics
NPI:1316969561
Name:MCCALL, CHARLES SINCLAIR (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:SINCLAIR
Last Name:MCCALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1538 13TH AVENUE
Mailing Address - Street 2:BLD A
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901
Mailing Address - Country:US
Mailing Address - Phone:706-323-4000
Mailing Address - Fax:706-323-4848
Practice Address - Street 1:1538 13TH AVENUE
Practice Address - Street 2:BLD A
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901
Practice Address - Country:US
Practice Address - Phone:706-323-4000
Practice Address - Fax:706-323-4848
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA042352208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00715492BMedicaid
GA34BDDPSOtherMEDICARE
GA34BDDPSOtherMEDICARE