Individual
DR. DEANNA C MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
653-1 W 8TH ST, 3RD FLOOR, LRC, JACKSONVILLE, FL 32209-6511
(904) 244-3112
Mailing address
653-1 W 8TH ST, 3RD FLOOR, LRC, JACKSONVILLE, FL 32209-6511
(904) 244-3112
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
ME 125274
FL
Other
Enumeration date
06/19/2007
Last updated
07/03/2016
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