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General NPI Number Information
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NPI Number | 1104803931
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Entity Type | Individual
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Provider Name | GEOFFREY M MCCULLEN MD
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 03/26/2014
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Provider Practice Location Address
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Address Line | 6900 A ST LINCOLN
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City | LINCOLN
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State | NE
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Zip | 68510-4120
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Country | US
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Telephone | 402-436-2000
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Fax | 402-436-2090
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Provider Business Mailing Address
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Address Line | 6900 A ST LINCOLN
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City | LINCOLN
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State | NE
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Zip | 68510-4120
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Country | US
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Telephone | 402-436-2000
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Fax | 402-436-2090
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 016484
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 21263
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License Number State | NE
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