Provider Demographics
NPI:1972790764
Name:CALLAWAY HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:CALLAWAY HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KETAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-215-8035
Mailing Address - Street 1:2507 HARRISON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4424
Mailing Address - Country:US
Mailing Address - Phone:850-215-8035
Mailing Address - Fax:850-215-8036
Practice Address - Street 1:2507 HARRISON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4424
Practice Address - Country:US
Practice Address - Phone:850-215-8035
Practice Address - Fax:850-215-8036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty