Individual
DIRK D MCGULLION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
463 MAIN ST W, RAINSVILLE, AL 35986
(256) 638-2020
(256) 638-7832
Mailing address
PO BOX 2120, RAINSVILLE, AL 35986-2120
(256) 638-2020
(256) 638-7832
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S818TA058
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000058647
—
AL
01
—
51058647
BCBS
AL
Enumeration date
09/06/2006
Last updated
02/21/2012
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