Provider Demographics
NPI:1528275443
Name:CALLAGHAN, JAMES STEPHEN JR (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STEPHEN
Last Name:CALLAGHAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 HOSPITAL DR STE 306
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9350
Mailing Address - Country:US
Mailing Address - Phone:570-522-4110
Mailing Address - Fax:570-768-3911
Practice Address - Street 1:7095 WESTBRANCH HWY STE 1100
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-6864
Practice Address - Country:US
Practice Address - Phone:570-524-5050
Practice Address - Fax:570-524-5250
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD435372207Q00000X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1021976320001Medicaid
PA2062158OtherHIGHMARK BLUE SHIELD
PA823578OtherFIRST PRIORITY HEALTH (SPECIALIST)
PA003178OtherFIRST PRIORITY HEALTH
PA9897174OtherAETNA
PA9897174OtherAETNA
PA2062158OtherHIGHMARK BLUE SHIELD