Basic Information
| Provider Information | |||||||||
| NPI: | 1235167040 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CALLIHAN | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | TODD | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | UK DIVISION OF HOSPITAL MEDICINE | ||||||||
| Address2: | 800 ROSE STREET, MN604 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405360298 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593236047 | ||||||||
| FaxNumber: | 8592573873 | ||||||||
| Practice Location | |||||||||
| Address1: | UK DIVISION OF HOSPITAL MEDICINE | ||||||||
| Address2: | 800 ROSE STREET, MN604 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405360298 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593236047 | ||||||||
| FaxNumber: | 8592573873 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2006 | ||||||||
| LastUpdateDate: | 05/29/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | PA683 | KY | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | 363A00000X | PA683 | KY | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AM0700X | PA683 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | P00017557 | 01 | KY | RAILROAD MEDICARE | OTHER | 95002283 | 05 | KY | MEDICAID |