Provider Demographics
NPI:1316580913
Name:CALELLA, DONALD JACOB (PA-C)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:JACOB
Last Name:CALELLA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1067 RIVERFRONT PKWY
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-2194
Mailing Address - Country:US
Mailing Address - Phone:423-602-9530
Mailing Address - Fax:423-560-7177
Practice Address - Street 1:1067 RIVERFRONT PKWY
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-2194
Practice Address - Country:US
Practice Address - Phone:423-602-9530
Practice Address - Fax:423-560-7177
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-26
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA9848363AM0700X
TN4183363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical