TIMOTHY CASEY MCCULLOUGH (NPI# 1881808947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881808947 |
| Entity Type | Individual |
| Full Name | TIMOTHY CASEY MCCULLOUGH |
| Credential | D.O. |
| Practice Address |
10730 Medlock Bridge Rd Ste 110 Johns Creek GA 30097 |
| Mailing Address |
1557 Janmar Rd Snellville GA 30078-5686 |
| Practice Telephone | 8608861956 |
| Mailing Telephone | 6783448900 |
| Mailing Fax Number | 4044927021 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2019-04-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 045215 | CT | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1557 Janmar Rd, Snellville, GA 300785686 | 6783448900 | 4044927021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275548927 | Timothy Mccullough | Physical Therapist | 11 Pleasant St., Smart Physical Therapy LLC, New London, NH 03257-5834 | 2006-07-30 |
| 1457727893 | Timothy Mccullough | Physician Assistant | 2400 Patterson St Ste 307, Nashville, TN 37203 | 2015-08-20 |
| 1093852428 | Timothy C. Mccullough | Chiropractor | 11003 Resource Pkwy, Suite 103, Houston, TX 77089-6141 | 2007-02-01 |
| 1841345725 | Timothy John Mccullough | Surgery | 1415 Portland Ave, Rochester, NY 14621-3038 | 2007-01-24 |
| 1275528184 | Timothy Mccullough | Emergency Medicine | 1000 E Cherry St, Troy, MO 63379-1513 | 2005-09-16 |
| Street Address |
10730 MEDLOCK BRIDGE RD STE 110 |
| City | JOHNS CREEK |
| State | GA |
| Zip Code | 30097 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730283284 | Vahan S Kassabian | Urology | 10730 Medlock Bridge Rd Ste 110, Johns Creek, GA 30097-2638 | 2006-09-12 |
| 1538636592 | Elena Victoria Garifallou | Physician Assistant | 10730 Medlock Bridge Rd Ste 110, Johns Creek, GA 30097 | 2018-10-29 |
| 1831505361 | Andrew Kenneth Ostrowski | Urology | 10730 Medlock Bridge Rd Ste 110, Johns Creek, GA 30097-2638 | 2014-07-03 |
| 1265843312 | Jason Lomboy | Urology | 10730 Medlock Bridge Rd Ste 110, Johns Creek, GA 30097-2638 | 2014-05-12 |
| 1578632808 | Diane L Spiva | Nurse Practitioner | 10730 Medlock Bridge Rd Ste 110, Johns Creek, GA 30097-2638 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659986057 | Herman Medical Solutions, LLC | Internal Medicine | 10700 Medlock Bridge Road, Suite 207, Duluth, GA 30097 | 2020-09-11 |
| 1649808619 | Kirsty Amber Ramirez | Behavior Technician | 218 Premiere Pkwy #500, Duluth, GA 30097 | 2020-03-27 |
| 1386277820 | Cristina Madalina Niculas | Pharmacist | Kroger Pharmacy 476, 6555 Sugarloaf Parkway, Duluth, GA 30097 | 2020-02-12 |
| 1619514924 | Opesdei Health Solutions | Home Health Aide | 6615 Abbotts Bridge Road, 6615 Abbotts Bridge Road Unit 1111, Johns Creek, GA 30097 | 2019-12-05 |
| 1700422979 | Ria Alexander | Nurse Practitioner | 6300 Hospital Parkway Ste 300, Johns Creek, GA 30097 | 2019-11-22 |
| 1043867765 | Mosesal Zakia White | Nurse Practitioner | 10680 Medlock Bridge Rd #102, Johns Creek, GA 30097 | 2019-08-19 |
| 1982187068 | Lighthouse Clinical Counseling, LLC | Counselor | 3883 Rogers Bridge Road, Suite 601, Duluth, GA 30097 | 2018-09-13 |
| 1376025643 | Faithe Beanne Kimsey | Counselor | 3883 Rogers Bridge Road Nw, Suite 601, Duluth, GA 30097 | 2018-09-04 |
| 1306330303 | Denise Jackson | Prosthetist | 11720 Medlock Bridge Rd Ste 155, Johns Creek, GA 30097 | 2018-06-21 |
| 1407363328 | Berkeley Van Dyke | Physical Therapist | 6335 Hospital Pkwy Ste 316, Johns Creek, GA 30097 | 2017-12-30 |
| Find all providers in zip 30097 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730283284 | Vahan S Kassabian | Urology | 10730 Medlock Bridge Rd Ste 110, Johns Creek, GA 30097-2638 | 2006-09-12 |
| 1104895762 | Jerry Yuan | Urology | 11459 Johns Creek Pkwy, Suite 170, Johns Creek, GA 30097-3515 | 2006-03-16 |
| 1598218570 | Advanced Urology Institute of Georgia | Urology | 10730 Medlock Bridge Rd, Suite 110, Johns Creek, GA 30097-1705 | 2016-07-26 |
| 1831505361 | Andrew Kenneth Ostrowski | Urology | 10730 Medlock Bridge Rd Ste 110, Johns Creek, GA 30097-2638 | 2014-07-03 |
| 1265843312 | Jason Lomboy | Urology | 10730 Medlock Bridge Rd Ste 110, Johns Creek, GA 30097-2638 | 2014-05-12 |
| 1861794265 | Georgia Urology Infertility Services | Urology | 11459 Johns Creek Pkwy, Suite 170, Johns Creek, GA 30097-3515 | 2010-11-17 |
| 1689847543 | Georgia Urology Pa | Urology | 11459 Johns Creek Pkwy, Suite 170, Johns Creek, GA 30097-3515 | 2008-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820576 | Advanced Urology Institute of Georgia PC | Urology | 2205 Riverstone Blvd Ste 101, Canton, GA 30114-5250 | 2020-04-23 |
| 1093369795 | Georgia Urology, Pa | Urology | 470 Northside Cherokee Blvd Ste 210, Canton, GA 30115-8029 | 2019-07-31 |
| 1790248953 | Michael Oberle | Urology | 1120 15th St Rm Baa 8415, Augusta, GA 30912-4050 | 2019-04-12 |
| 1598220915 | Effingham Urology, LLC | Urology | 613 Towne Park Dr W Ste 204, Rincon, GA 31326-5183 | 2019-02-11 |
| 1275008351 | Center for Special Surgery LLC | Urology | 11660 Alpharetta Hwy Ste 720, Roswell, GA 30076-4916 | 2018-10-04 |
| 1295200426 | Paul Edward Henson Jr. | Urology | 1837 Wood Valley Dr, Dalton, GA 30720-3846 | 2018-10-03 |
| 1477033124 | Urological Health Center, PC | Urology | 1770 Watson Boulevard, Warner Robins, GA 31093 | 2018-08-21 |
| 1982182655 | Advanced Urology Institute of Georgia | Urology | 1460 S Johnson Ferry Rd, Atlanta, GA 30319-4301 | 2018-08-03 |
| 1922597517 | Wguasc, LLC | Urology | 150 Clinic Ave Ste 203, Carrollton, GA 30117-4402 | 2018-05-09 |
| 1841788395 | Houston Physician Specialists, LLC | Urology | 233 N Houston Rd Ste 100, Warner Robins, GA 31093-8944 | 2018-04-30 |
| Find all providers with the same taxonomy | ||||
| City | JOHNS CREEK |
| Zip Code | 30097 |
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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.