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NPI Code Detail

MEDICARE: ZEKE MCCULLEN NEWPORT PSYD

MEDICARE: ZEKE MCCULLEN NEWPORT PSYD
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
1103T00000XPsychologist4235TN

General Provider Information

NPI Number : 1619859253
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZEKE MCCULLEN NEWPORT PSYD
Provider Business Mailing Address
First Line : 1923 SULPHUR SPRINGS RD
Second Line :
City : MORRISTOWN
State : TN
Zip : 37813-5654
Country : US
Telephone Number : 423-317-9344
Fax Number : 423-714-2355
Provider Business Practice Location Address
First Line : 2018 WESTERN AVE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37921-5718
Country : US
Telephone Number : 865-544-0406
Fax Number : 865-544-0480
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2025
Last Update Date : 02/10/2026

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