DR. GARRY ONEIL MCCULLOCH (NPI# 1699065805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699065805 |
| Entity Type | Individual |
| Full Name | DR. GARRY ONEIL MCCULLOCH |
| Credential | M.D. |
| Practice Address |
1267 Highway 54 W Ste 2200 Fayetteville GA 30214-2110 |
| Practice Telephone | (770) 716-0051 |
| Mailing Telephone | 7707160051 |
| Enumeration Date | 2011-04-10 |
| Last Update Date | 2019-03-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
078088 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1267 HIGHWAY 54 W STE 2200 |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-2110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912984568 | Arun Prahash | Internal Medicine | 1267 Highway 54 W Ste 2200, Fayetteville, GA 30214-2110 | 2005-12-26 |
| 1003429531 | Brittney Shay Pasko | Nurse Practitioner | 1267 Highway 54 W Ste 2200, Fayetteville, GA 30214-2110 | 2020-08-25 |
| 1326484213 | Paul Constantine Karagiannis | Internal Medicine | 1267 Highway 54 W Ste 2200, Fayetteville, GA 30214-2110 | 2013-05-17 |
| 1598021180 | Rani Ashwin Shah | Internal Medicine | 1267 Highway 54 W Ste 2200, Fayetteville, GA 30214-2110 | 2012-04-08 |
| 1699054775 | Tesfaye Telila | Internal Medicine | 1267 Highway 54 W Ste 2200, Fayetteville, GA 30214 | 2011-08-08 |
| 1043506272 | Sushee C Gadde | Internal Medicine | 1267 Highway 54 W Ste 2200, Fayetteville, GA 30214 | 2011-06-27 |
| 1912293812 | Mitkumar Patel | Internal Medicine | 1267 Highway 54 W Ste 2200, Fayetteville, GA 30214-2110 | 2011-06-20 |
| 1548495849 | Sujith Kuruvilla | Internal Medicine | 1267 Highway 54 W Ste 2200, Fayetteville, GA 30214-2110 | 2009-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| 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 |
|---|---|---|---|---|
| 1831406677 | Hana Smith | Internal Medicine | 4101 Medical Center Dr Fl 2, Fayetteville, NY 13066-6600 | 2010-08-31 |
| 1689874166 | Ashu Dhanjal | Internal Medicine | 1695 E Rainforest Rd Ste 4, Fayetteville, AR 72703 | 2007-07-23 |
| 1902942931 | Agodichi U Nwosu | Internal Medicine | 3613b Raeford Rd, Fayetteville, NC 28304-2113 | 2007-01-29 |
| 1164591947 | Soliman A Soliman | Internal Medicine | 3211 N Northhills Blvd Ste 110, Fayetteville, AR 72703-5602 | 2006-11-07 |
| 1093759839 | Deepak K Parashara | Internal Medicine | 2460 N. Common Drive, Fayetteville, AR 72703 | 2006-06-15 |
| 1962460550 | Manesh Thomas | Internal Medicine | 3650 Cape Center Dr, Fayetteville, NC 28304-2139 | 2006-05-03 |
| 1811961683 | Martin E Bacon | Internal Medicine | 3634 Cape Center Drive, Fayetteville, NC 28304 | 2006-02-16 |
| 1720051105 | Charles West Jacocks Iv | Internal Medicine | 2300 Ramsey St Rm 304-a, Fayetteville, NC 28301-3856 | 2006-02-08 |
| 1154393080 | Brenda May-depaola | Internal Medicine | 3634 Cape Center Dr, Fayetteville, NC 28304-4406 | 2006-02-03 |
| 1154305704 | Carolina Heart Physicians Pllc | Internal Medicine | 3613 Raeford Rd, Suite B, Fayetteville, NC 28304-2113 | 2005-12-06 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on DR. GARRY ONEIL MCCULLOCH.
| 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.