Basic Information
| Provider Information | |||||||||
| NPI: | 1386194843 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MCCULLEY ALLERGY SINUS & ASTHMA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2155 WEST ST | ||||||||
| Address2: | |||||||||
| City: | GERMANTOWN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381383856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9016233323 | ||||||||
| FaxNumber: | 9016233324 | ||||||||
| Practice Location | |||||||||
| Address1: | 2155 WEST ST | ||||||||
| Address2: | |||||||||
| City: | GERMANTOWN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381383856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9016233323 | ||||||||
| FaxNumber: | 9016233324 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2016 | ||||||||
| LastUpdateDate: | 11/22/2021 | ||||||||
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| AuthorizedOfficialLastName: | MAHARREY | ||||||||
| AuthorizedOfficialFirstName: | CATHY | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 9016233323 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 11/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207K00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Allergy & Immunology |
No ID Information.