Individual
SAMUEL SCOTT MCCULLOUGH III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
102 HAZELTON CV, GLUCKSTADT, MS 39110-6961
(601) 633-9017
Mailing address
106 EAGLE CV, MADISON, MS 39110-6629
(601) 260-9830
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
903614
MS
Other
Enumeration date
10/12/2019
Last updated
03/15/2026
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