Ryan T Mcculloch in Chubbuck - Physician Assistant
Ryan T Mcculloch - NPI 1720195530
Ryan T Mcculloch is a Physician Assistant in Chubbuck, Idaho. Ryan T Mcculloch practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Ryan T Mcculloch is 1720195530. The last update date is 2010-12-20.
Ryan T Mcculloch's current location address is 147 W Chubbuck Rd, Chubbuck, Idaho. You can contact this provider via phone number 2082387546 and fax number 2082379643. The mailing address for Ryan T Mcculloch is 147 W Chubbuck Rd, Chubbuck, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Ryan T Mcculloch |
|---|---|
| Address | 147 W Chubbuck Rd, Chubbuck, Idaho |
| Phone Number | 2082387546 |
| Fax Number | 2082379643 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1720195530 |
|---|---|
| Provider Enumeration Date | 2006-08-25 |
| Last Updated Date | 2010-12-20 |
Provider Mailing Address Detail
| Address | 147 W Chubbuck Rd |
|---|---|
| City | Chubbuck |
| State | Idaho (ID) |
| Post Code | 832022314 |
| Phone Number | 2082387546 |
| Fax Number | 2082379643 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA405 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| P00329828 | ID | RAILROAD MEDICARE PTAN | |
| 806497600 | ID | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Ryan T Mcculloch?
The Ryan T Mcculloch has been issued the NPI (National Provider Identifier) 1720195530 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical address where Ryan T Mcculloch is geographically located?
The Ryan T Mcculloch is physically situated at the following location: 147 W Chubbuck Rd, Chubbuck, ID, 832022314.
What is Ryan T Mcculloch's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Ryan T Mcculloch is Physician Assistant, and the taxonomy classification code that categorizes this area of expertise is 363A00000X.
On what date was the 1720195530 assigned to Ryan T Mcculloch?
The Ryan T Mcculloch was issued its 1720195530 on 2006-08-25, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Ryan T Mcculloch most recently updated?
The details pertaining to the Ryan T Mcculloch, including its address, specialty, and other relevant information, were last refreshed on 2010-12-20.