Individual
GARY BRIAN MCCALLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MEDICAL PARK DR, SALINE MEMORIAL HOSPITAL, BENTON, AR 72205
(501) 626-9478
Mailing address
PO BOX 165257, LITTLE ROCK, AR 72216-5257
(501) 626-9478
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
E-3712
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150657001
—
AR
01
—
5M648
BCBS
AR
Enumeration date
06/23/2006
Last updated
12/26/2013
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