Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 8404 | KY |
Y | 213EG0000X | General Practice | 8404 | KY |
NPI | 1003830381 |
---|---|
Provider Name | Dr. Jeffrey E Cull |
First Address | Wichita Falls, TX 76308-4200 |
Second Address | Sheppard Afb, TX 76311-3482 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VAD 000 | (02) | TX |