Individual provider · Type 1 NPI

Gordon Derek Callaway, PA-C

Medical Physician Assistant · Lebanon, NH

NPI number 1316968100 Active

Practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X0592 (NH)

Medical Physician Assistant: Definition to come...

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About NPI 1316968100

Gordon Derek Callaway, PA-C's National Provider Identifier is 1316968100, issued on Jul 21, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Lebanon, NH. The record was last updated on Oct 28, 2011.