Basic Information
| Provider Information | |||||||||
| NPI: | 1013989995 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CALLAHAN | ||||||||
| FirstName: | BARRY | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2447 | ||||||||
| Address2: | |||||||||
| City: | TUSCALOOSA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 354032447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053450192 | ||||||||
| FaxNumber: | 2054644507 | ||||||||
| Practice Location | |||||||||
| Address1: | 305 PAUL W BRYANT DR E | ||||||||
| Address2: | |||||||||
| City: | TUSCALOOSA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 354012055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053450192 | ||||||||
| FaxNumber: | 2054644507 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2006 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 33914 | TN | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0106X | ME102420 | FL | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery | 207XS0106X | 33914 | TN | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery | 207XS0106X | 19772 | AL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery |
ID Information
| ID | Type | State | Issuer | Description | 206729 | 05 | AL | MEDICAID | 4011644 | 01 | TN | BCBS OF TN | OTHER | 61852 | 01 | FL | BLUE CROSS BLUE SHIELD | OTHER | 207049 | 05 | AL | MEDICAID | 208156 | 05 | AL | MEDICAID | 206727 | 05 | AL | MEDICAID | 3853851 | 05 | TN | MEDICAID | 511-99733 | 01 | AL | BCBS | OTHER | 206198 | 05 | AL | MEDICAID | 511-99731 | 01 | AL | BCBS | OTHER | 180360 | 05 | AL | MEDICAID | 4010644 | 01 | TN | BCBS | OTHER | 511-71913 | 01 | AL | BCBS | OTHER | 511-99732 | 01 | AL | BCBS | OTHER |