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Individual
DR. JOHN MICHAEL MCCULLOUGH
Active
Individual
DR. JOHN MICHAEL MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E6140
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127591906
WELLMED MEDICAID
TX
01
—
347313YPL5
WELLMED MEDICARE
TX
Enumeration date
08/29/2005
Last updated
02/19/2018
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