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Organization

ECLECTIC FAMILY CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GARY LEE MCCULLOCH SR. M.D. (OWNER)
(334) 541-3020
Entity
Organization

Contact information

Practice address
575 CLAUD RD, ECLECTIC, AL 36024-6318
(334) 541-3020
(334) 541-3109
Mailing address
PO BOX 241120, ECLECTIC, AL 36024-0018
(334) 541-3020
(334) 541-3109

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12809
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
99530
AL
Enumeration date
11/09/2006
Last updated
08/22/2020
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