Wayne Leon Callen, MD
Individual provider Active NPI Specialist · Leadville, CO
NPI 1326100249 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1326100249
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- Practice address
- 825 W 6TH St
Leadville, CO 80461-2205 - Phone
- (719) 486-1264
- Fax
- (719) 486-1286
- NPI assigned
- Dec 15, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Yes |
Addresses
Primary practice location
825 W 6TH St
Leadville, CO 80461-2205
Mailing address
825 W 6TH St
Leadville, CO 80461-2205
Phone (719) 486-1264
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01220813 | Medicaid | CO |
Other providers in Leadville, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.