Individual
DYLAN REESE MCCOLLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
918 DRAYTON AVE, ELBA, AL 36323-1448
(334) 493-5713
(334) 493-5750
Mailing address
PO BOX 1010, OPP, AL 36467-1010
(334) 493-5713
(334) 493-5750
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
F06200571
AL
363LF0000X
Family Nurse Practitioner
Primary
1-140157
AL
Other
Enumeration date
06/22/2020
Last updated
11/07/2022
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