R Brooks Callihan DMD PSC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

4699 Issued in KY

Legal business name

R BROOKS CALLIHAN DMD PSC

Practice address

219 Main St
Greenup, KY 41144-1068

Phone

(606) 473-6322

Fax

(606) 473-0200

NPI assigned

Jan 12, 2012

Last updated

Jan 12, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

R Brooks Callihan, DMD

Title

President

Phone

(606) 473-6322

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326326400000",
    "number": "1821368499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 MAIN ST",
            "city": "GREENUP",
            "state": "KY",
            "postal_code": "411441068",
            "telephone_number": "606-473-6322",
            "fax_number": "606-473-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 MAIN ST",
            "city": "GREENUP",
            "state": "KY",
            "postal_code": "411441068",
            "telephone_number": "606-473-6322",
            "fax_number": "606-473-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R BROOKS CALLIHAN DMD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-01-12",
        "status": "A",
        "authorized_official_last_name": "CALLIHAN",
        "authorized_official_first_name": "R",
        "authorized_official_middle_name": "BROOKS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-473-6322",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "KY",
            "license": "4699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60046992",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Greenup, KY
• Providers in Greenup, KY by specialty
• Exclusive Provider Organization in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.