Provider Demographics
NPI:1528115334
Name:CALLISON, JOHN JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:CALLISON
Suffix:JR
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 1:1940 ALCOA HWY STE E210
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-2264
Mailing Address - Country:US
Mailing Address - Phone:865-524-7471
Mailing Address - Fax:
Practice Address - Street 1:1940 ALCOA HWY STE E210
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-2264
Practice Address - Country:US
Practice Address - Phone:865-524-7471
Practice Address - Fax:865-305-8878
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000043909207PE0004X, 207R00000X, 207RP1001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program