Organization
HEART MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN MCCULLOUGH MD (OWNER)
(912) 536-7699
Entity
Organization
Contact information
Practice address
1103 PLAZA AVE, EASTMAN, GA 31023-6788
(912) 536-7699
Mailing address
731 WAVERLY PT, MACON, GA 31210-7546
(912) 536-7699
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
11/15/2019
Last updated
04/13/2022
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