Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 35038419C | OH |
Y | 207W00000X | Ophthalmologist | 35038419 | OH |
NPI | 1033104518 |
---|---|
Provider Name | Dr. George Franklin Calloway II |
First Address | Westerville, OH 43081-8723 |
Second Address | Westerville, OH 43081-8723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2005 |
Last Update Date | 09/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0380967 | (05) | OH |
A36991 | (02) | OH |