Provider Demographics
NPI:1164695417
Name:J.MICHAEL CALHOUN MD PA
Entity Type:Organization
Organization Name:J.MICHAEL CALHOUN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-771-2000
Mailing Address - Street 1:4020 RICHARDS RD
Mailing Address - Street 2:SUITE I
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2650
Mailing Address - Country:US
Mailing Address - Phone:501-353-2123
Mailing Address - Fax:501-771-4672
Practice Address - Street 1:4020 RICHARDS RD
Practice Address - Street 2:SUITE I
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2650
Practice Address - Country:US
Practice Address - Phone:501-353-2123
Practice Address - Fax:501-771-4672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC6803207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR52483OtherAR BLUE CROSS
AR2848993OtherCIGNA
AR310156900OtherDEPT OF LABOR
ARP00145513OtherRAIL ROAD MEDICARE
AR5F041OtherBLUE CROSS/BLUE SHIELD
AR1376531814OtherINDIVIDUAL NPI
AR111633001Medicaid
AR5F041OtherBLUE CROSS/BLUE SHIELD
AR2848993OtherCIGNA