Mccullough, John Jeffrey

Mccullough, John Jeffrey is an individual health care provider with primary practice located at 420 Delaware Street Se, Room 760 University Of Minnesota Physicians, Minneapolis MN 55455. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Blood Banking & Transfusion Medicine, Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine. Allopathic & Osteopathic Physicians / Blood Banking & Transfusion Medicine is his primary health care specialty. Mccullough, John Jeffrey can be contacted via phone (612) 626-0622.

Contact Information

Primary practice address
420 Delaware Street Se, Room 760 University Of Minnesota Physicians Minneapolis MN 55455
Phone: (612) 626-0622
Fax: (612) 626-2696
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Blood Banking & Transfusion Medicine 207ZB0001X 19412 Minnesota
Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine 207ZP0105X 19412 Minnesota

Profile Details

NPI number 1275605768
LBN Legal business name Mccullough, John Jeffrey
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2006
Last updated Jul 8th, 2007 - about 19 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 1275605768 NPPES
Wisconsin MEDICAID 34601900
Wisconsin Other 11-74546
Wisconsin MEDICAID 0513234
Wisconsin Other 101363
Wisconsin Other 768254
Wisconsin Other 1009234
Wisconsin Other HP22294
Wisconsin Other 1122551
Wisconsin Other 2T225MC

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