Individual
GARY LEE MCCULLOCH SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
575 CLAUD RD, ECLECTIC, AL 36024-6318
(334) 541-3020
(334) 541-3109
Mailing address
PO BOX 241120, ECLECTIC, AL 36024
(334) 541-3020
(334) 541-3109
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12809
AL
Other
Enumeration date
05/05/2006
Last updated
12/17/2009
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