Individual
DR. TIMOTHY JOHN MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
109 BRIDGE ST STE 202, DANVILLE, VA 24541-1222
(434) 792-5964
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
(434) 792-5964
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101260704
VA
208600000X
Surgery Physician
149086
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00988243
—
NY
Enumeration date
01/24/2007
Last updated
03/29/2023
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