Healthcare Provider Details

I. General information

NPI: 1356260624
Provider Name (Legal Business Name): JAMES WILSON CULVEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIR
FORT CARSON CO
80913-4613
US

IV. Provider business mailing address

3447 CELESTIAL LN
MARIANNA FL
32448-7179
US

V. Phone/Fax

Practice location:
  • Phone: 850-451-7588
  • Fax:
Mailing address:
  • Phone: 850-451-7588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberE3783151
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: