ROBERT W. MCCULLOUGH (NPI# 1235214503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235214503 |
| Entity Type | Individual |
| Full Name | ROBERT W. MCCULLOUGH |
| Credential | O.D. |
| Practice Address |
137 W Mill St Jonesboro GA 30236-3572 |
| Practice Telephone | 7704715037 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2008-02-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 836-T | GA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000178032A1 | 05 | |
| GA | BLUE CROSS/BLUE SHIELD | 52146571 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790958304 | Robert Mccullough | Social Worker | 209 Black Oak Dr, Saint Peters, MO 63376-1740 | 2008-04-04 |
| 1659331486 | Robert Dale Mccullough II | Internal Medicine | 5803 E 75th Pl, Tulsa, OK 74136-7255 | 2006-03-24 |
| 1164926788 | Robert Lyle Mccullough | Dentist | 11820 Sw King James Pl Ste 20, Tigard, OR 97224-2481 | 2018-03-20 |
| 1386006922 | Robert E Mccullough II | Counselor | 1905 Continental Pl, Mount Vernon, WA 98273-5633 | 2016-03-23 |
| 1972892453 | Robert Michael Mccullough | Emergency Medicine | 2301 Holmes St, Tmc-hospital Hill, Kansas City, MO 64108-2640 | 2011-04-05 |
| 1740490739 | Robert Mccullough | Pharmacist | 1173 W Main St, Whitewater, WI 53190-1672 | 2007-05-22 |
| Street Address |
137 W MILL ST |
| City | JONESBORO |
| State | GA |
| Zip Code | 30236-3572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639348162 | Dr. Robert W. Mccullough | Optometrist | 137 W Mill St, Jonesboro, GA 30236-3572 | 2008-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123362 | Life Source Counseling & Consulting, LLC | Clinic/Center | 118 North Avenue, Suite A, Jonesboro, GA 30236 | 2020-04-25 |
| 1639609555 | New Beginnings Behavioral Counseling,llc | Social Worker | 9456 S Main St Ste E2, Jonesboro, GA 30236 | 2017-06-13 |
| 1437696762 | Clarissa Alexandra Poole | Counselor | 2106 Fair Ridge Ct, Jonesboro, GA 30236 | 2017-01-25 |
| 1588012892 | Sundance Healthcare Service Inc | In Home Supportive Care | 7861 Collinswood Court, Jonesboro, GA 30236 | 2016-05-26 |
| 1942669205 | Adrianne Smiley Gurley | Occupational Therapist | 1299 Battlecreek Rd Ste 210, Jonesboro, GA 30236 | 2016-02-15 |
| 1336505809 | Integrated Health Center | Dentist | 8600 Tara Blvd, Suite D, Jonesboro, GA 30236 | 2016-01-13 |
| 1467827402 | Surrell Porter | Nurse Practitioner | 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 | 2015-12-02 |
| 1740688910 | Jacqueline Carolyn Edwards | Registered Nurse | 8081 Tara Blvd, 265, Jonesboro, GA 30236 | 2014-12-19 |
| 1770991861 | Lower Extremity Diagnostics, LLC | Podiatrist | 6911 Tara Boulevard, Jonesboro, GA 30236 | 2014-08-01 |
| 1760899710 | Fresenius Medical Care Jonesboro, LLC | Clinic/Center | 8060 Summitt Business Parkway, Jonesboro, GA 30236 | 2014-07-22 |
| Find all providers in zip 30236 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811240948 | Visioncheck | Optometrist | 105 Links Cir, Jonesboro, GA 30238-6308 | 2012-10-26 |
| 1700166394 | The Eyes Have It, LLC | Optometrist | 6525 Tara Blvd, Suite 134, Jonesboro, GA 30236-1227 | 2011-08-26 |
| 1538345970 | Harrell Eye Clinic Pa | Optometrist | 1716 Executive Sq, Jonesboro, AR 72401-6092 | 2008-01-16 |
| 1942493234 | Jacob Paul Moll | Optometrist | 3705 E Johnson Ave, Jonesboro, AR 72401-1858 | 2007-08-21 |
| 1093814048 | Larry Mcnamara | Optometrist | 514 Southwest Dr, Jonesboro, AR 72401-5857 | 2006-09-22 |
| 1306942503 | Michael Don Killough | Optometrist | 1801 Red Wolf Blvd, Suite 101, Jonesboro, AR 72401-5450 | 2006-09-15 |
| 1346356300 | Louis J. Layton | Optometrist | 2706 Phillips Dr, Jonesboro, AR 72401-7332 | 2006-08-22 |
| 1992716286 | Cade Malone Wilson | Optometrist | 1000 Windover Rd, Ste. C, Jonesboro, AR 72401-6066 | 2006-08-11 |
| 1750397675 | J. Brian Gray | Optometrist | 114 E Oak Ave, Jonesboro, AR 72401-3561 | 2006-07-31 |
| 1881638328 | Jonathan Blake Ross | Optometrist | 1815 E Highland Dr, Jonesboro, AR 72401-6118 | 2006-06-15 |
| Find all providers in JONESBORO | ||||
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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.