Provider Demographics
NPI:1588619092
Name:MCCALLEN, JULIE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:MCCALLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6400 S FIDDLERS GREEN CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4953
Mailing Address - Country:US
Mailing Address - Phone:720-387-3681
Mailing Address - Fax:720-302-2992
Practice Address - Street 1:6400 S FIDDLERS GREEN CIR STE 200
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-4953
Practice Address - Country:US
Practice Address - Phone:720-387-3681
Practice Address - Fax:720-302-2992
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33302207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07328711Medicaid
COF03818Medicare UPIN
CO07328711Medicaid