Provider Demographics
NPI:1588939631
Name:CALLAND, KRISTY A (DO)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:A
Last Name:CALLAND
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:A
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1215 DUFF AVENUE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-3014
Mailing Address - Country:US
Mailing Address - Phone:515-239-4432
Mailing Address - Fax:515-239-4754
Practice Address - Street 1:1215 DUFF AVENUE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-3014
Practice Address - Country:US
Practice Address - Phone:515-239-4432
Practice Address - Fax:515-239-4754
Is Sole Proprietor?:No
Enumeration Date:2012-03-21
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IA04693207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program