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NPI Code Detail

MEDICARE: HEATH KEAY MCCULLOUGH MD

MEDICARE: HEATH KEAY 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
12085R0202XDiagnostic Radiology Physician2008-01825NC
22085R0204XVascular & Interventional Radiology Physician2008-01825NC

General Provider Information

NPI Number : 1366641243
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATH KEAY MCCULLOUGH MD
Provider Business Mailing Address
First Line : PO BOX 85378
Second Line :
City : CHICAGO
State : IL
Zip : 60689-5378
Country : US
Telephone Number : 336-274-6682
Fax Number : 336-274-8097
Provider Business Practice Location Address
First Line : 1331 N ELM ST STE 200
Second Line :
City : GREENSBORO
State : NC
Zip : 27401-6304
Country : US
Telephone Number : 336-274-6682
Fax Number : 336-274-8097
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2007
Last Update Date : 12/01/2025

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Directions to “ HEATH KEAY MCCULLOUGH MD” Practice Location

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