Individual
THOMAS W MCCULLOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1104 WALNUT DR, ARDMORE, OK 73401-2353
(580) 226-0543
(580) 226-2284
Mailing address
1104 WALNUT DR, ARDMORE, OK 73401-2353
(580) 226-0543
(580) 226-2284
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1878
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100106140C
—
OK
Enumeration date
07/26/2006
Last updated
10/24/2022
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