Provider Demographics
NPI:1447519400
Name:MCCALEB, HOLLY SLATTON (MD)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:SLATTON
Last Name:MCCALEB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 26TH ST
Mailing Address - Street 2:
Mailing Address - City:HALEYVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35565-1719
Mailing Address - Country:US
Mailing Address - Phone:205-486-5234
Mailing Address - Fax:205-486-5232
Practice Address - Street 1:904 26TH ST
Practice Address - Street 2:
Practice Address - City:HALEYVILLE
Practice Address - State:AL
Practice Address - Zip Code:35565-1719
Practice Address - Country:US
Practice Address - Phone:205-486-5234
Practice Address - Fax:205-486-5232
Is Sole Proprietor?:No
Enumeration Date:2012-05-11
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD33201207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL176472Medicaid
AL101I087355Medicare PIN