Provider Demographics
NPI:1598087249
Name:PAUL R CALLEGARI MD PC
Entity Type:Organization
Organization Name:PAUL R CALLEGARI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:CALLEGARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-494-8200
Mailing Address - Street 1:6585 S. YALE
Mailing Address - Street 2:SUITE 1050
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8330
Mailing Address - Country:US
Mailing Address - Phone:918-494-8200
Mailing Address - Fax:918-494-8204
Practice Address - Street 1:6585 S. YALE
Practice Address - Street 2:SUITE 1050
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8330
Practice Address - Country:US
Practice Address - Phone:918-494-8200
Practice Address - Fax:918-494-8204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19993208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty