Callaway, Juaquita D

Callaway, Juaquita D is an sole proprietor health care provider with primary practice located at 2785 Lawrenceville Hwy Ste 107, Decatur GA 30033. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as her primary health care specialty. Callaway, Juaquita D can be contacted via phone (678) 205-0405.

Contact Information

Primary practice address
2785 Lawrenceville Hwy Ste 107 Decatur GA 30033
Phone: (678) 205-0405
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 033289 Georgia

Profile Details

NPI number 1629075544
LBN Legal business name Callaway, Juaquita D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2005
Last updated Jun 7th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629075544 NPPES
Georgia MEDICAID 000532749A

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