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Organization

JOHN M MCNULTY MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN M MCNULTY MD (SELF)
(208) 784-7017
Entity
Organization

Contact information

Practice address
740 MCKINLEY AVE, KELLOGG, ID 83837-2693
(208) 783-1267
Mailing address
862 CHERRY CREEK RD, ST MARIES, ID 83861-9329
(208) 245-9233

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M7646
ID

Other

Enumeration date
03/14/2008
Last updated
03/14/2008
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