Provider Demographics
NPI:1144504077
Name:CALLICOTT, JOSEPH HANDEL III (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:HANDEL
Last Name:CALLICOTT
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5012 WORTHINGTON DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-2747
Mailing Address - Country:US
Mailing Address - Phone:301-320-0399
Mailing Address - Fax:
Practice Address - Street 1:5012 WORTHINGTON DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-2747
Practice Address - Country:US
Practice Address - Phone:301-320-0399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00478462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry