Individual
DR. JOSEPH E MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4321 WASHINGTON ST, SUITE 5600, KANSAS CITY, MO 64111-5961
(816) 561-2000
Mailing address
4321 WASHINGTON ST, SUITE 5600, KANSAS CITY, MO 64111-5961
(816) 561-2000
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
R3L06
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16236011
BLUE CROSS BLUE SHIELD KC
—
05
—
206905903
—
MO
Enumeration date
08/19/2006
Last updated
11/02/2015
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