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NPI Code Detail

MEDICARE: LANE MCCULLOUGH

MEDICARE: LANE MCCULLOUGH
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
1174400000XSpecialist
2235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1285160119
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANE MCCULLOUGH
Provider Business Mailing Address
First Line : 1000 W BULLDOG BLVD
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72701-4714
Country : US
Telephone Number : 479-444-3000
Fax Number :
Provider Business Practice Location Address
First Line : 1000 W BULLDOG BLVD
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72701-4714
Country : US
Telephone Number : 479-444-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2017
Last Update Date : 12/06/2022

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Directions to “ LANE MCCULLOUGH ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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