Provider Demographics
NPI:1588160394
Name:O'CALLAHAN, JOLEY BEELER (MD)
Entity type:Individual
Prefix:
First Name:JOLEY
Middle Name:BEELER
Last Name:O'CALLAHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOLEY
Other - Middle Name:ENGH
Other - Last Name:BEELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9411 N OAK TRFY STE LL1
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2262
Mailing Address - Country:US
Mailing Address - Phone:816-691-1655
Mailing Address - Fax:
Practice Address - Street 1:2750 CLAY EDWARDS DR STE 600C
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3258
Practice Address - Country:US
Practice Address - Phone:816-691-5201
Practice Address - Fax:816-346-7063
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MO20240195182085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program