Provider Demographics
NPI:1356569305
Name:MCCALL, JEFFREY E (CRNA)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:E
Last Name:MCCALL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 627
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36831-0627
Mailing Address - Country:US
Mailing Address - Phone:334-528-2499
Mailing Address - Fax:334-528-2497
Practice Address - Street 1:2000 PEPPERELL PKWY
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801
Practice Address - Country:US
Practice Address - Phone:334-528-2499
Practice Address - Fax:334-528-2497
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-098216367500000X
GARN201075367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALGROUP E725Medicare PIN
AL510I430008Medicare PIN