SUMNER R CULLOM (NPI# 1902885015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902885015 |
| Entity Type | Individual |
| Full Name | SUMNER R CULLOM |
| Credential | M.D. |
| Practice Address |
260 W Broad St Lepanto AR 72354-0723 |
| Mailing Address |
260 W Broad St Lepanto AR 72354-0000 |
| Practice Telephone | 8704753180 |
| Practice Fax Number | 8704753185 |
| Mailing Telephone | 8704753180 |
| Mailing Fax Number | 8704753185 |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2016-03-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | ARC4583 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 103504001 | 05 |
| Street Address |
260 W BROAD ST |
| City | LEPANTO |
| State | AR |
| Zip Code | 72354-0723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992298756 | Hannah Nicole Tyler | Case Manager/Care Coordinator | 122 Will Henry Dr., Lepanto, AR 72354 | 2018-06-07 |
| 1295952182 | East Arkansas Family Health Center Inc. | Pharmacy | 102 W Broad, Lepanto, AR 72354 | 2007-04-20 |
| 1922139062 | East Arkansas Family Health Center Inc. | Clinic/Center | 102 West Broad, Lepanto, AR 72354 | 2007-03-08 |
| 1265568745 | Jones Drug Store | Pharmacy | 216 Greenwood Ave South, Lepanto, AR 72354 | 2007-02-26 |
| 1316041957 | T W Wagner Inc | Clinic/Center | 331 Broad Street, Suite B, Lepanto, AR 72354 | 2006-09-12 |
| 1053528778 | Lisa J Booker | Nurse Practitioner | 260 West Broad Street, Lepanto, AR 72354-0000 | 2007-05-16 |
| 1225373749 | Joseph Daniel Mcguinness | Physician Assistant | 102 W Broad St, Lepanto, AR 72354-2200 | 2012-12-10 |
| 1538444252 | Mike Miller | Pharmacist | 102 W Broad St, Lepanto, AR 72354-2200 | 2011-10-13 |
| 1366608895 | East Arkansas Family Health Center | Dentist | 102 W Broad St, Lepanto, AR 72354-2200 | 2008-08-04 |
| 1114994035 | Kristi Renee Allen | Nurse Practitioner | 102 W Broad St, Lepanto, AR 72354-2200 | 2006-03-01 |
| Find all providers in zip 72354 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1083269690 | University of Arkansas At Monticello | General Practice | 663 University Drive, Monticello, AR 71656 | 2019-08-09 |
| 1912492786 | Chelsea Brown | General Practice | 6309 Highway 5 N, Bryant, AR 72022-8506 | 2018-06-25 |
| 1205345154 | Lakeside Walk-in Clinic Pllc | General Practice | 2230 Malvern Ave Ste E, Hot Springs, AR 71901-8000 | 2017-09-22 |
| 1558897595 | Epoch-nwa Pllc | General Practice | 5100 W Pauline Whitaker Pkwy, Ste. 110, Rogers, AR 72758-8335 | 2017-05-11 |
| 1023540655 | Aaron M Smith | General Practice | Varner Unit State Hwy 388, Gould, AR 71643 | 2017-04-02 |
| 1942749148 | Reece Lewis Crow | General Practice | 34 Windsor Road, Little Rock, AR 72212 | 2017-02-21 |
| Find all providers with the same taxonomy | ||||
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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.