Mccullough, Timothy John

Mccullough, Timothy John is an sole proprietor health care provider with primary practice located at 109 Bridge St Ste 202 , Danville VA 24541-1222. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Mccullough, Timothy John can be contacted via phone (434) 792-5964.

Contact Information

Primary practice address
109 Bridge St Ste 202 Danville VA 24541-1222
Phone: (434) 792-5964
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 149086 New York
Allopathic & Osteopathic Physicians / Surgery 208600000X 0101260704 Virginia

Profile Details

NPI number 1841345725
LBN Legal business name Mccullough, Timothy John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 24th, 2007
Last updated Mar 29th, 2023 - about 3 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 1841345725 NPPES
New York MEDICAID 00988243

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