Individual
ROBERT W. MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
137 W MILL ST, JONESBORO, GA 30236-3572
(770) 471-5037
Mailing address
137 W MILL ST, JONESBORO, GA 30236-3572
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
836-T
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000178032A1
—
GA
01
—
52146571
BLUE CROSS/BLUE SHIELD
GA
Enumeration date
10/26/2006
Last updated
02/10/2026
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