Individual
DR. JEFFREY P CULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 N 1ST ST # STQ, SPRINGFIELD, IL 62781-0001
(217) 788-3245
Mailing address
3050 MONTVALE DR, SPRINGFIELD, IL 62704-4290
(217) 726-8096
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036055252
IL
2085R0202X
Diagnostic Radiology Physician
2017013708
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036055252
—
IL
Enumeration date
01/26/2006
Last updated
06/29/2021
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