Provider Demographics
NPI:1467675033
Name:DR JOHN E CALLINAN OD PC
Entity Type:Organization
Organization Name:DR JOHN E CALLINAN OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:CALLINAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:508-875-7662
Mailing Address - Street 1:149 CONCORD STREET
Mailing Address - Street 2:5 ARCADE
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702
Mailing Address - Country:US
Mailing Address - Phone:508-875-7662
Mailing Address - Fax:508-875-7662
Practice Address - Street 1:149 CONCORD STREET
Practice Address - Street 2:5 ARCADE
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702
Practice Address - Country:US
Practice Address - Phone:508-875-7662
Practice Address - Fax:508-875-7662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAOD2111152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6000000003OtherHARVARD PILGRIM
410018810OtherRAILROAD MEDICARE
0021770OtherNEIGHBORHOOD HEALTH
MA9731229Medicaid
MA0315931Medicaid
135934OtherEYE MED
MAW20015OtherBLUE CROSS GROUP #
MAW15511OtherBLUE CROSS PROV #
MAW15511OtherBLUE CROSS PROV #
6000000003OtherHARVARD PILGRIM
135934OtherEYE MED
=========OtherMUTUAL OF OMAHA
0021770OtherNEIGHBORHOOD HEALTH
6000000003OtherHARVARD PILGRIM
=========OtherNETWORK HEALTH