Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | J9653 | TX |
N | 207QG0300X | Family Doctor - Geriatric Medicine | J9653 | TX |
NPI | 1356456446 |
---|---|
Provider Name | John Whitfield Culberson |
First Address | Lubbock, TX 79408-5865 |
Second Address | Lubbock, TX 79430-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 10/01/2020 |