Wayne M Mccullough in Frankfort - Sports Medicine
Wayne M Mccullough - NPI 1033284179
Wayne M Mccullough is a Sports Medicine in Frankfort, Illinois. Wayne M Mccullough practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Wayne M Mccullough is 1033284179. The last update date is 2015-09-21.
Wayne M Mccullough's current location address is 21813 Cappel Ln, Frankfort, Illinois. You can contact this provider via phone number 9785496818 and fax number 8476740892. The mailing address for Wayne M Mccullough is 21813 Cappel Ln, Frankfort, Illinois. To know further, please read the information below!
Provider Profile Detail
Provider Name | Wayne M Mccullough |
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Address | 21813 Cappel Ln, Frankfort, Illinois |
Phone Number | 9785496818 |
Fax Number | 8476740892 |
Sole Proprietor | Y |
Credentials | -- |
NPI Number Detail
NPI Number | 1033284179 |
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Provider Enumeration Date | 2006-11-22 |
Last Updated Date | 2015-09-21 |
Provider Mailing Address Detail
Address | 21813 Cappel Ln |
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City | Frankfort |
State | Illinois (IL) |
Post Code | 604232275 |
Phone Number | 9785496818 |
Fax Number | 8476740892 |
Provider's Primary Taxonomy Detail
Speciality | Sports Medicine |
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Taxonomy | 213Es0000X |
Licence No | 1939 |
Definition: A doctor of podiatric medicine who focuses on treating athletic injuries related to the lower extremities. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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363037 | MA | -- |
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What is the unique 10-digit identification code issued to Wayne M Mccullough by the Centers for Medicare & Medicaid Services?
The Wayne M Mccullough has been assigned the NPI (National Provider Identifier) 1033284179 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Where is the Wayne M Mccullough located?
The Wayne M Mccullough is located at 21813 Cappel Ln, Frankfort, IL 604232275.
What is Wayne M Mccullough's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Wayne M Mccullough's specialized field of practice is Sports Medicine, and the corresponding taxonomy code that categorizes this area of specialization is 213Es0000X.
On what date was the 1033284179 assigned to Wayne M Mccullough?
The Wayne M Mccullough was issued its 1033284179 on 2006-11-22, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Wayne M Mccullough's details last updated?
The information pertaining to the Wayne M Mccullough, including its address, specialty, and other details, was most recently updated on 2015-09-21.