MEDICARE: DR. GEORGE M MCCULLARS M.D., PH.D.

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
1	207R00000X	Internal Medicine Physician	MD.10172	AL

General Provider Information

NPI Number	:	1700879418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE M MCCULLARS M.D., PH.D.

Provider Business Mailing Address
First Line	:	11035 CELESTE RD
Second Line	:
City	:	SARALAND
State	:	AL
Zip	:	36571-9707
Country	:	US
Telephone Number	:	251-342-1808
Fax Number	:	251-342-1838

Provider Business Practice Location Address
First Line	:	1 TIMBER WAY STE 202
Second Line	:
City	:	DAPHNE
State	:	AL
Zip	:	36527-5634
Country	:	US
Telephone Number	:	251-342-1808
Fax Number	:	251-342-1838

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2005
Last Update Date	:	05/19/2021

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