Provider Demographics
NPI:1659527919
Name:CALDERON, LOUIS AARON (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:AARON
Last Name:CALDERON
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 1:322 SUTHERLAND PL NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-2327
Mailing Address - Country:US
Mailing Address - Phone:404-371-1190
Mailing Address - Fax:
Practice Address - Street 1:3408 COVINGTON HIGHWAY
Practice Address - Street 2:GEORGIA DEPARTMENT OF JUVENILE JUSTICE
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032
Practice Address - Country:US
Practice Address - Phone:404-508-6509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0565332084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry