Individual
DR. CASEY KENT MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1478 EAST HIGHWAY 162, MONTEZUMA CREEK, UT 84534-0130
(435) 651-3700
(435) 678-0608
Mailing address
PO BOX 130, MONTEZUMA CREEK, UT 84534-0130
(435) 651-3291
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
86533281205
UT
Other
Enumeration date
06/21/2010
Last updated
03/18/2022
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