Provider Demographics
NPI:1639165640
Name:CALAWAY, CHRIS ALLAN (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:ALLAN
Last Name:CALAWAY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 CONSERVATORY DR
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-4281
Mailing Address - Country:US
Mailing Address - Phone:330-745-4404
Mailing Address - Fax:330-753-9162
Practice Address - Street 1:31 CONSERVATORY DR
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-4281
Practice Address - Country:US
Practice Address - Phone:330-745-4404
Practice Address - Fax:330-753-9162
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3522 196152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH410041656OtherRAILROAD MEDICARE
OH000000141884OtherANTHEM
OHTRICAREOther341904624
OH0461665Medicaid
OH54435OtherQUALCHOICE
OH2200659OtherUNITED HEALTH CARE
OH4663605OtherAETNA
OH026652001OtherADMINISTAR
OH54435OtherQUALCHOICE
OHTRICAREOther341904624