Basic Information
| Provider Information | |||||||||
| NPI: | 1518914985 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCALL | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | ALVIN | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9007 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658089007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4178753462 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3555 S NATIONAL AVE | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658077310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4178753800 | ||||||||
| FaxNumber: | 4178753176 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2006 | ||||||||
| LastUpdateDate: | 12/27/2018 | ||||||||
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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 | 363AS0400X | 107722 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
ID Information
| ID | Type | State | Issuer | Description | 18942 | 01 | MO | COX HEALTH PLANS | OTHER | 0215424 | 01 | WA | DEPARTMENT OF LABOR WA | OTHER | 149005 | 01 | MO | BLUE CROSS/CHOICE | OTHER | 502277007 | 05 | MO | MEDICAID | 572313 | 01 | MO | HEALTHLINK | OTHER | S35583 | 01 | MO | USPS (W/C) | OTHER | 15083 | 01 | MO | COX HEALTH PLANS UPI | OTHER | 220024495 | 05 | MO | MEDICAID | 0600213 | 01 | MO | UNITED HEALTHCARE | OTHER |