Basic Information
| Provider Information | |||||||||
| NPI: | 1528275443 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CALLAGHAN | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | STEPHEN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 HOSPITAL DR STE 306 | ||||||||
| Address2: | |||||||||
| City: | LEWISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178379350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705224110 | ||||||||
| FaxNumber: | 5707683911 | ||||||||
| Practice Location | |||||||||
| Address1: | 7095 WESTBRANCH HWY STE 1100 | ||||||||
| Address2: | |||||||||
| City: | LEWISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178376864 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705245050 | ||||||||
| FaxNumber: | 5705245250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2007 | ||||||||
| LastUpdateDate: | 06/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD435372 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 2083P0011X | MD435372 | PA | N | Allopathic & Osteopathic Physicians | Preventive Medicine | Undersea and Hyperbaric Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1021976320001 | 05 | PA | MEDICAID | 2062158 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 823578 | 01 | PA | FIRST PRIORITY HEALTH (SPECIALIST) | OTHER | 003178 | 01 | PA | FIRST PRIORITY HEALTH | OTHER | 9897174 | 01 | PA | AETNA | OTHER |