| William A Mccullough, PA-C, MCMSC | |
|
527 W 3rd St, Konawa, OK 74849-1415 | |
| (580) 925-3286 | |
| (580) 925-9149 |
| Full Name | William A Mccullough |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 527 W 3rd St, Konawa, Oklahoma |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992082713 | NPI | - | NPPES |
| 15-01493 | Other | KS | STATE OF KANSAS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 15-01493 (Kansas) | Secondary |
| 363A00000X | Physician Assistant | 2144 (Oklahoma) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| William A Mccullough, PA-C, MCMSC 527 W 3rd St, Konawa, OK 74849-1415 Ph: (580) 925-3286 | William A Mccullough, PA-C, MCMSC 527 W 3rd St, Konawa, OK 74849-1415 Ph: (580) 925-3286 |
Gwendolyn Lyles, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 527 W 3rd St, Konawa, OK 74849 Phone: 580-925-3286 | |
Mr. Erron Cody Proctor, PAC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 527 W 3rd St, Konawa, OK 74849 Phone: 580-925-3286 Fax: 580-925-2362 | |
Tina Marie Wainwright, P.A-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 527 W 3rd St, Konawa, OK 74849 Phone: 580-925-3286 Fax: 580-925-9149 |