Provider Demographics
NPI:1467407387
Name:BRENT ALAN CALE, M.D., PC
Entity Type:Organization
Organization Name:BRENT ALAN CALE, M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:CALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-228-2535
Mailing Address - Street 1:PO BOX 1645
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30903-1645
Mailing Address - Country:US
Mailing Address - Phone:706-228-2535
Mailing Address - Fax:706-228-3433
Practice Address - Street 1:3101 US HIGHWAY 280
Practice Address - Street 2:
Practice Address - City:AILEY
Practice Address - State:GA
Practice Address - Zip Code:30410-3659
Practice Address - Country:US
Practice Address - Phone:706-228-2535
Practice Address - Fax:706-228-3433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA054256207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH26966Medicare UPIN
GAGRP6533Medicare ID - Type Unspecified