Basic Information
| Provider Information | |||||||||
| NPI: | 1215924964 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CALLAGHAN | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | L. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 498 INVERNESS TRL | ||||||||
| Address2: | |||||||||
| City: | DAKOTA DUNES | ||||||||
| State: | SD | ||||||||
| PostalCode: | 570495244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6055400358 | ||||||||
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| Practice Location | |||||||||
| Address1: | 624 JONES STREET | ||||||||
| Address2: | SUITE 5400 | ||||||||
| City: | SIOUX CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 511015283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152792510 | ||||||||
| FaxNumber: | 7122792519 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2005 | ||||||||
| LastUpdateDate: | 08/27/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 3086 | IA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 6033 | SD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 3086 | IA | N | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.