Provider Demographics
NPI:1477545671
Name:MCCALLA, RODNEY TAY (MD)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:TAY
Last Name:MCCALLA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5101 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1614
Mailing Address - Country:US
Mailing Address - Phone:816-478-4200
Mailing Address - Fax:816-875-2598
Practice Address - Street 1:4801 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1628
Practice Address - Country:US
Practice Address - Phone:913-721-3387
Practice Address - Fax:816-875-2598
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2024-07-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2022008352208600000X
KS04-33137208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH89669Medicare UPIN