Individual
MR. JOHN PATRICK MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
7744 CONNER RD, POWELL, TN 37849-3509
(865) 546-9751
Mailing address
1275 DICK LONAS RD UNIT 101, KNOXVILLE, TN 37909-1383
(865) 584-4747
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
33790
TN
363LF0000X
Family Nurse Practitioner
Primary
33790
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q082264
—
TN
Enumeration date
04/05/2023
Last updated
03/21/2024
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