Charles Larry Mccullouch Jr, MD - Medicare Family Medicine in Brooksville, MS

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Charles Larry Mccullouch Jr, MD is a medicare enrolled "Family Medicine" physician in Brooksville, Mississippi. His current practice location is 1560 North Oliver St., Brooksville, Mississippi. You can reach out to his office (for appointments etc.) via phone at (662) 738-4424.

Charles Larry Mccullouch Jr is licensed to practice in Mississippi (license number 13953) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1710964754.

Contact Information

Charles Larry Mccullouch Jr, MD
1560 North Oliver St.,
Brooksville, MS 39739
(662) 738-4424
(662) 738-4615

Map and Direction




Physician's Profile

Full NameCharles Larry Mccullouch Jr
GenderMale
SpecialityFamily Medicine
Location1560 North Oliver St., Brooksville, Mississippi
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1710964754
  • Provider Enumeration Date: 12/30/2005
  • Last Update Date: 06/19/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 8729066923
  • Enrollment ID: I20040713001089

Medical Identifiers

Medical identifiers for Charles Larry Mccullouch Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1710964754NPI-NPPES
P00147884OtherRAILROAD MEDICARE
00125739MedicaidMS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 13953 (Mississippi)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Charles Larry Mccullouch Jr allows following entities to bill medicare on his behalf.
Entity NameIndependent Healthcare Management Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1306909734
PECOS PAC ID: 0840197232
Enrollment ID: O20031215000487
Entity NameCovington County Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1518260330
PECOS PAC ID: 4183517253
Enrollment ID: O20040203000816
Entity NameSouth Sunflower County Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1184679292
PECOS PAC ID: 6709771637
Enrollment ID: O20040218000979
Entity NameIndependent Healthcare Management Inc
Entity TypePart A Provider - Critical Access Hospital
Entity IdentifiersNPI Number: 1306909734
PECOS PAC ID: 0840197232
Enrollment ID: O20120111000488
Entity NameBoa Vida Hospital Of Aberdeen Ms Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1710405741
PECOS PAC ID: 0244505840
Enrollment ID: O20171128003460
Entity NameWmc Emergency Services Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1336786235
PECOS PAC ID: 5698102465
Enrollment ID: O20200218000805

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Charles Larry Mccullouch Jr is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Charles Larry Mccullouch Jr, MD
1560 North Oliver St.,
Brooksville, MS 39739

Ph: (662) 738-4424		Charles Larry Mccullouch Jr, MD
1560 North Oliver St.,
Brooksville, MS 39739

Ph: (662) 738-4424

Reviews and Comments


Family Medicine Doctors in Brooksville, MS


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.