Provider Demographics
NPI:1487215489
Name:DAY, CALVIN E
Entity Type:Individual
Prefix:
First Name:CALVIN
Middle Name:E
Last Name:DAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10201 REPUBLIC LN
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72209-8438
Mailing Address - Country:US
Mailing Address - Phone:501-352-6595
Mailing Address - Fax:
Practice Address - Street 1:10201 REPUBLIC LN
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-8438
Practice Address - Country:US
Practice Address - Phone:501-352-6595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver