THOMAS W MCCULLOH (NPI# 1407879661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407879661 |
| Entity Type | Individual |
| Full Name | THOMAS W MCCULLOH |
| Credential | DO |
| Practice Address |
1104 Walnut Dr Ardmore OK 73401-2353 |
| Mailing Address |
1306 12th Ave Nw Ardmore OK 73401-1285 |
| Practice Telephone | 5802260543 |
| Practice Fax Number | 5802262284 |
| Mailing Telephone | 5802236003 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-10-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 1878 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100106140C | 05 |
| Street Address |
1104 WALNUT DR |
| City | ARDMORE |
| State | OK |
| Zip Code | 73401-2353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770504037 | Miguel Antonio Camacho-garrido | Pediatrics | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-07-22 |
| 1013374271 | Shawn Fadum | Physician Assistant | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2016-01-19 |
| 1346618980 | Family Health Skilled Services LLC | Family Medicine | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2015-09-14 |
| 1952476251 | Osu Center for Health Sciences | Clinic/Center | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-11-21 |
| 1497853774 | Melissa Cashman, Ph.d.,p.c.,inc. | Psychologist | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-09-20 |
| 1871698514 | Melissa Cashman | Psychologist | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-09-14 |
| 1497862304 | Miguel A. Camacho, Md P.C. | Pediatrics | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-08-24 |
| 1871607903 | Michael W Carnahan | Family Medicine | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-08-18 |
| 1568576619 | Family Practice Associates | Family Medicine | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-08-18 |
| 1972616183 | Sharon E Hall | Nurse Practitioner | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-08-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497391452 | Abbie Deeann Mclemore | Nurse Practitioner | 915 10th Ave, Ardmore, OK 73401 | 2019-11-25 |
| 1790349991 | Shirley Denise Brown | Licensed Psychiatric Technician | 1219 Kst N.w, 1219 Kst N.w, Ardmore, OK 73401 | 2019-04-24 |
| 1427512359 | Billy Joe Oshields | Case Manager/Care Coordinator | 6862 State Hwy 199 Ardmore Oklahoma, 6862 State Hwy 199, Ardmore, OK 73401 | 2019-01-24 |
| 1174007595 | Tawnya Dawn Peery | Nurse Practitioner | 1108 W. Walnut Drive, Ardmore, OK 73401 | 2018-09-21 |
| 1679055016 | Teresa Marie Hernandez | Behavior Technician | 1219 K St. Nw, Ardmore, OK 73401 | 2018-09-01 |
| 1063991974 | Sawyer Rae Shamburger | Occupational Therapy Assistant | 208 North Praire St, Pilot Point, TX 73401 | 2018-08-10 |
| 1417473521 | Chelsye Bacon | Peer Specialist | 905 Holiday Drive, Ardmore, OK 73401 | 2017-08-21 |
| 1003279746 | Jeni Presley | Marriage & Family Therapist | Outpatient Services-ardmore; 2510 Chickasaw Dr., Strong Family Development;, Ardmore, OK 73401 | 2016-03-31 |
| 1982080909 | Alison Hill | Pharmacist | 1111 N. Commerce, Ardmore, OK 73401 | 2015-07-31 |
| 1316346547 | Olivia Larae Carrell | Counselor | 15 Monroe Street Ne, Ardmore, OK 73401 | 2014-08-13 |
| Find all providers in zip 73401 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407237704 | Primecare Family Clinic LLC | Family Medicine | 1405 4th Ave Nw # 311, Ardmore, OK 73401-2708 | 2015-06-11 |
| 1295025765 | Jorge Luis Carmona Rodriguez | Family Medicine | 731 12th Ave Nw Ste 100, Ardmore, OK 73401-5762 | 2011-04-18 |
| 1588989719 | Paul Maury Prusky | Family Medicine | 25 East Athens Ave, Ardmore, PA 19003 | 2010-03-31 |
| 1518025469 | Vicky Berberian | Family Medicine | 647 Ardmore Ave, Ardmore, PA 19003-1831 | 2006-12-04 |
| 1922044494 | Lister Health Care Corporation | Family Medicine | 30320 Al Highway 53 Ste B&c, Ardmore, AL 35739-8766 | 2006-06-21 |
| 1437109394 | Anna Christella Burson | Family Medicine | 720 Grand Ave, Ardmore, OK 73401-4343 | 2006-05-11 |
| 1053377937 | Steven K Watkins | Family Medicine | 908 N Rockford Rd, Suite G, Ardmore, OK 73401-2540 | 2006-04-21 |
| 1740269430 | Karen L. Abrams | Family Medicine | 233 E. Lancaster Ave, Suite 303a, Ardmore, PA 19003 | 2006-01-11 |
| 1689652075 | Phillip Alton Nokes | Family Medicine | 1105 Michelin Rd, Michelin Family Health Center, Ardmore, OK 73401-1085 | 2006-01-05 |
| 1285611160 | James Forrestal | Family Medicine | 830 16th Ave Nw, Ardmore, OK 73401-1818 | 2005-12-30 |
| Find all providers in ARDMORE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.