Thomas Eldon Callahan, D.O.
Individual provider Active NPI Pediatrics Physician · Dubuque, IA
NPI 1528262136 · NPPES record last updated Jul 6, 2010
Key facts
- NPI
- 1528262136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 4069 (IA)
- Practice address
- 1500 Associates Dr
Dubuque, IA 52002-2201 - Phone
- (563) 584-4440
- Fax
- (563) 584-4427
- NPI assigned
- Jun 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100825000827 | IA | Practitioner - Pediatric Medicine | 2466576624 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4069 | IA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Associates Clinic P C | Current |
Accepting new patients |
Locations
1500 Associates Dr
Dubuque, IA 52002
Phone (563) 584-4100
1000 Langworthy St
Dubuque, IA 52001
Phone (563) 584-3455
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4069 | IA | Yes |
Addresses
Primary practice location
1500 Associates Dr
Dubuque, IA 52002-2201
Mailing address
1500 Associates Dr
Dubuque, IA 52002-2201
Phone (563) 584-4100
Other providers in Dubuque, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.