RICKY JUSTIN MCCULLOUGH (NPI# 1245469519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245469519 |
| Entity Type | Individual |
| Full Name | RICKY JUSTIN MCCULLOUGH |
| Credential | M.D. |
| Practice Address |
1103 Plaza Ave Eastman GA 31023-6788 |
| Mailing Address |
731 Waverly Pt Macon GA 31210-7546 |
| Practice Telephone | 4782542644 |
| Practice Fax Number | 4782544924 |
| Mailing Telephone | 9125367699 |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2019-12-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
003572 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841325370 | Ricky Wayne Mccullough | Emergency Medicine | 48 Moosup Valley Rd, Foster, RI 02825-1236 | 2007-02-23 |
| Street Address |
1103 PLAZA AVE |
| City | EASTMAN |
| State | GA |
| Zip Code | 31023-6788 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043215668 | Donald H Rosenbaum | Orthopaedic Surgery | 1103 Plaza Ave, Eastman, GA 31023-6788 | 2005-06-20 |
| 1558906396 | Heartmd | Internal Medicine | 1103 Plaza Ave, Eastman, GA 31023-6788 | 2019-11-15 |
| 1568799302 | Rosenbaum Orthopaedics, LLC | Orthopaedic Surgery | 1103 Plaza Ave, Eastman, GA 31023-6788 | 2009-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821555913 | Community Service Board of Middle Georgia | Day Training, Developmentally Disabled Services | 1444 Morgan Creek Dr, Eastman, GA 31023 | 2019-02-25 |
| 1174832232 | Lynetta Davies | Counselor | 17 Tanner Dr, Eastmon, GA 31023 | 2010-10-06 |
| 1467774380 | Dustin Phillip Smith | Chiropractor | 285 Plaza Avenue, Eastman, GA 31023 | 2010-02-19 |
| 1639311145 | D&b Home Care Inc | Durable Medical Equipment & Medical Supplies | 714 Medical Center Drive, Eastman, GA 31023 | 2009-03-30 |
| 1427273465 | Hospice Care Options Inc | Hospice Care, Community Based | 715 Legion Dr, Eastman, GA 31023 | 2007-04-16 |
| 1740318625 | Dana W Mullis | Dentist | 1003 Plaza Ave, Eastman, GA 31023 | 2007-03-01 |
| 1285787630 | 801 Legion LLC | Skilled Nursing Facility | 815 Legion Dr, Eastman, GA 31023 | 2007-01-19 |
| 1396813317 | Womens Health PC | Obstetrics & Gynecology | 821 Plaza Ave, Suite B, Eastman, GA 31023 | 2006-11-30 |
| 1932294170 | John D Roberts | Ophthalmology | 917 Plaza Avenue, Eastman, GA 31023 | 2006-10-04 |
| 1215030978 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 535 Oak St, Eastman, GA 31023 | 2006-09-07 |
| Find all providers in zip 31023 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558906396 | Heartmd | Internal Medicine | 1103 Plaza Ave, Eastman, GA 31023-6788 | 2019-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013571033 | Norihiko Kamioka | Internal Medicine | 1364 Clifton Rd Ne Ste D422, Atlanta, GA 30322-1059 | 2019-04-24 |
| 1992229884 | Medical Software, LLC | Internal Medicine | 3855 Pleasant Hill Rd Ste 350, Duluth, GA 30096-8093 | 2017-08-01 |
| 1215399456 | Raymond Mai | Internal Medicine | 1120 15th St # 6518, Augusta, GA 30912-1436 | 2016-03-27 |
| 1043684954 | Columbus Cardiology Associates, PC | Internal Medicine | 905 N Jackson St, Ste B, Americus, GA 31719-3089 | 2015-11-17 |
| 1649693045 | Avantgarde Consultants, Inc. | Internal Medicine | 10945 State Bridge Rd Ste 401-708, Alpharetta, GA 30022-8164 | 2014-01-22 |
| 1194153973 | Epic Group 8 | Internal Medicine | 760 Old Roswell Rd, Suite 114, Roswell, GA 30076-2279 | 2013-10-14 |
| 1982940987 | Southeastern Cardiovascular Associates LLC | Internal Medicine | 1076 Bermuda Run, Statesboro, GA 30458-0858 | 2012-12-19 |
| 1265798763 | Sulay Pankaj Patel | Internal Medicine | 101 Woodruff Circle Wmb 1013, Atlanta, GA 30322 | 2012-04-09 |
| 1073879573 | Ozlem Bilen | Internal Medicine | Emory University Cardiovascular, 101 Woodruff Circle, Wmb 3004, Atlanta, GA 30322-0001 | 2012-04-09 |
| 1962779611 | Cardiac Consultants of Central Georgia | Internal Medicine | 2024 Watson Blvd Bldg 1, Warner Robins, GA 31093-3624 | 2011-11-23 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on RICKY JUSTIN MCCULLOUGH.
| 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.