Healthcare Provider Details

I. General information

NPI: 1578476552
Provider Name (Legal Business Name): GESC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 ABERDEEN BLVD STE B
GASTONIA NC
28054-0642
US

IV. Provider business mailing address

2325 ABERDEEN BLVD STE A
GASTONIA NC
28054-0642
US

V. Phone/Fax

Practice location:
  • Phone: 704-853-3937
  • Fax:
Mailing address:
  • Phone: 704-853-3937
  • Fax: 704-853-8029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: BOBBY K MCCULLEN JR.
Title or Position: MEDICAL DIRECTOR/OWNER
Credential: MD
Phone: 704-853-3937