Callaway, Juaquita D
Callaway, Juaquita D is an sole proprietor health care provider with primary practice located at 2785 Lawrenceville Hwy Ste 107, Decatur GA 30033. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as her primary health care specialty. Callaway, Juaquita D can be contacted via phone (678) 205-0405.Contact Information
Primary practice address
2785 Lawrenceville Hwy Ste 107
Decatur GA 30033
Phone: (678) 205-0405
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | 033289 | Georgia |
Profile Details
| NPI number | 1629075544 |
|---|---|
| LBN Legal business name | Callaway, Juaquita D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 7th, 2005 |
| Last updated | Jun 7th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629075544 | NPPES |
| Georgia | MEDICAID | 000532749A |
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