Callaway, Jenna

Callaway, Jenna is an individual health care provider with primary practice located at 1919 E Thomas Rd , Phoenix AZ 85016-7710. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Callaway, Jenna can be contacted via phone (602) 933-0945.

Contact Information

Primary practice address
1919 E Thomas Rd Phoenix AZ 85016-7710
Phone: (602) 933-0945
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X Arizona
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 69515 Arizona

Profile Details

NPI number 1760001580
LBN Legal business name Callaway, Jenna
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2020
Last updated Oct 25th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760001580 NPPES
Arizona MEDICAID 128421

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