Organization
CULLAIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL CULLEN M.D. (OWNER/PSYCHIATRIST)
(608) 238-6998
Entity
Organization
Contact information
Practice address
6333 ODANA RD STE 20, MADISON, WI 53719-1170
(608) 270-2511
Mailing address
1414 W SKYLINE DR, MADISON, WI 53705-1135
(608) 212-4822
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
21235-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31687500
—
WI
Enumeration date
11/15/2011
Last updated
01/03/2012
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