Individual
DR. KURT THOMAS CALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
418 S HAMILTON ST, SUITE 109, PAINTED POST, NY 14870-9705
(607) 936-2089
(607) 936-8176
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
279917
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04159835
—
NY
05
—
103055103
—
PA
Enumeration date
06/28/2013
Last updated
06/09/2016
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