Provider Demographics
NPI:1497976294
Name:WHERRY, CALEN (MD)
Entity Type:Individual
Prefix:DR
First Name:CALEN
Middle Name:
Last Name:WHERRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355TH MEDICAL GROUP
Mailing Address - Street 2:4175 S. ALAMO AVENUE
Mailing Address - City:DAVIS-MONTHAN AFB
Mailing Address - State:AZ
Mailing Address - Zip Code:85707-4405
Mailing Address - Country:US
Mailing Address - Phone:520-228-2615
Mailing Address - Fax:520-228-2627
Practice Address - Street 1:355TH MEDICAL GROUP
Practice Address - Street 2:280 FIRST STREET, BLDG 23
Practice Address - City:DAVIS MONTHAN AFB
Practice Address - State:AZ
Practice Address - Zip Code:85707-4405
Practice Address - Country:US
Practice Address - Phone:520-228-2615
Practice Address - Fax:520-228-2627
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.2013132083X0100X, 2083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine