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Organization

CALLAWAY INTERNAL MEDICINE GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. FREDERICK M. WILSON M.D. (PRESIDENT)
(573) 642-4242
Entity
Organization

Contact information

Practice address
2613 FAIRWAY DR, SUITE D, FULTON, MO 65251-3936
(573) 642-4242
(573) 592-0560
Mailing address
2613 FAIRWAY DR, SUITE D, FULTON, MO 65251-3936
(573) 642-4242
(573) 592-0560

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
113229
MO

Other

Enumeration date
09/13/2007
Last updated
09/13/2007
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