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NPI Code Detail

MEDICARE: DR. JOHN MICHAEL MCCULLOUGH MD

MEDICARE: DR. JOHN MICHAEL MCCULLOUGH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianE6140TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2347313YPL5OTHERTXWELLMED MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407849144
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN MICHAEL MCCULLOUGH MD
Provider Business Mailing Address
First Line : 1739 SCHERTZ PKWY
Second Line :
City : SCHERTZ
State : TX
Zip : 78154-1639
Country : US
Telephone Number : 210-491-8179
Fax Number : 210-590-2664
Provider Business Practice Location Address
First Line : 1739 SCHERTZ PKWY
Second Line :
City : SCHERTZ
State : TX
Zip : 78154-1639
Country : US
Telephone Number : 210-491-8179
Fax Number : 210-590-2664
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2005
Last Update Date : 02/19/2018

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Directions to “ DR. JOHN MICHAEL MCCULLOUGH MD” Practice Location

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