Individual
DR. KATHRYN M MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3929 N GLOSTER ST, TUPELO, MS 38804-0915
(662) 840-4624
(662) 840-9426
Mailing address
1525 LARKSPUR PL, TUPELO, MS 38801-6976
(662) 840-4624
(662) 840-9426
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
483
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03888791
—
MS
Enumeration date
11/15/2007
Last updated
11/11/2021
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