Callaway, Jody Carlton

Callaway, Jody Carlton is an individual health care provider with primary practice located at 105 Skyline Dr , Russellville AR 72801-3363. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Gynecology. Allopathic & Osteopathic Physicians / Gynecology is his primary health care specialty. Callaway, Jody Carlton can be contacted via phone (479) 968-2345.

Contact Information

Primary practice address
105 Skyline Dr Russellville AR 72801-3363
Phone: (479) 968-2345
Fax: (479) 890-7125
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X C-6385 Arkansas
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X C-6385 Arkansas

Profile Details

NPI number 1245296961
LBN Legal business name Callaway, Jody Carlton
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2006
Last updated Aug 22nd, 2023 - about last year

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 1245296961 NPPES
Arkansas MEDICAID 113544001

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