Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CHARLES LARRY MCCULLOUCH JR., MD
Active Sole ProprietorCHARLES LARRY MCCULLOUCH JR., MD is a Family Medicine healthcare provider located in BROOKSVILLE, Mississippi. NPI 1710964754 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · BROOKSVILLE, MS
Registration Details
- NPI Number
- 1710964754
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 30, 2005 (20.596041732825 yrs)
- Last Updated
- Jun 19, 2018
- License
-
13953 (MS)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1560 NORTH OLIVER ST.BROOKSVILLE, MS, 39739Browse MS providers · Browse ZIP 39739
- Phone
- 6627384424
- Fax
- 6627384615
- Primary Specialty
-
Family Medicine
207Q00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.