Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 2017-00916 | NC |
NPI | 1023156734 |
---|---|
Provider Name | Dr. Jeffrey Alan Culp |
First Address | Dickson, TN 37055-2856 |
Second Address | Dickson, TN 37055-2856 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 07/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036126551 | ILLINOIS MEDICAL LICENSE (01) | IL |
53246 | TENNESSEE MEDICAL LICENSE (01) | TN |