Mccullough, Barry G

Mccullough, Barry G is an individual health care provider with primary practice located at 2140 Kingsley Ave Ste 1 , Orange Park FL 32073-5129. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Mccullough, Barry G can be contacted via phone (904) 272-7500.

Contact Information

Primary practice address
2140 Kingsley Ave Ste 1 Orange Park FL 32073-5129
Phone: (904) 272-7500
Fax: (904) 272-7502
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA1751 Florida

Profile Details

NPI number 1225057151
LBN Legal business name Mccullough, Barry G
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated May 6th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225057151 NPPES
Florida MEDICAID 2908077-00

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