Provider Demographics
NPI:1740784412
Name:CALLOWAY, JASON (RPSG, RST, CCSH)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:CALLOWAY
Suffix:
Gender:M
Credentials:RPSG, RST, CCSH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:974 BETHEL RD STE E
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-2467
Mailing Address - Country:US
Mailing Address - Phone:614-827-0010
Mailing Address - Fax:614-885-3975
Practice Address - Street 1:974 BETHEL RD STE E
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2467
Practice Address - Country:US
Practice Address - Phone:614-827-0010
Practice Address - Fax:614-885-3975
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH621174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator