Individual
DR. BOBBY KENNETH MCCULLEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2325 ABERDEEN BLVD, STE A, GASTONIA, NC 28054-0614
(704) 853-3937
(704) 853-0840
Mailing address
2325 ABERDEEN BLVD, STE A, GASTONIA, NC 28054-0614
(704) 853-3937
(704) 853-0840
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
38135
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11679
PARTNERS MEDICARE CHOICE
NC
01
—
45612
MEDCOST
NC
01
—
56862
BLUE CROSS OF NC
NC
05
—
8956862
—
NC
Enumeration date
05/24/2005
Last updated
03/12/2008
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