Kathryn McCullough OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

KATHRYN MCCULLOUGH OD LLC

Practice address

1028 Fawn Dr
Tupelo, MS 38804-1924

Phone

(662) 871-4169

NPI assigned

Mar 25, 2015

Last updated

Mar 25, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kathryn McCullough, OD

Title

Owner

Phone

(662) 871-4169

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427241600000",
    "number": "1659765998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 FAWN DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388041924",
            "telephone_number": "662-871-4169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 FAWN DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388041924",
            "telephone_number": "662-871-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHRYN MCCULLOUGH OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-25",
        "last_updated": "2015-03-25",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-871-4169",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.