Sumner R Cullom M D P a

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

C4583 Issued in AR

Legal business name

SUMNER R CULLOM M D P A

Doing business as

Cullom Rural Health Clinic

Practice address

700 W Keiser Ave
Osceola, AR 72370-3506

Phone

(870) 563-6512

Fax

(870) 563-5013

NPI assigned

May 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Sumner R Cullom, M.D.

Title

Owner

Phone

(870) 563-6512

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cullom Rural Health Clinic Doing business as

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271203200000",
    "number": "1861609570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W KEISER AVE",
            "city": "OSCEOLA",
            "state": "AR",
            "postal_code": "723703500",
            "telephone_number": "870-563-6512",
            "fax_number": "870-563-5013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W KEISER AVE",
            "city": "OSCEOLA",
            "state": "AR",
            "postal_code": "723703506",
            "telephone_number": "870-563-6512",
            "fax_number": "870-563-5013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMNER R CULLOM M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2010-04-14",
        "status": "A",
        "authorized_official_last_name": "CULLOM",
        "authorized_official_first_name": "SUMNER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-563-6512",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "AR",
            "license": "C4583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "5C697",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cullom Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• April Stiles, RN
• Amanda Marie Strange, LPC
• Sheena Stringer, ECDS
• Tracey Strop-Allen
• Angela Stroughter, MHPP
• Super D Drug Acquisition Co (Star Pharmacy)
• Tonya Renee Swann, LMSW
• Joe Carter Thomas, D.D.S.
• Kimberly Dawn Tomblin, LAC
• Bryce Trible

• Rural Health Clinic/Center in Osceola, AR
• Providers in Osceola, AR by specialty
• Rural Health Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; 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.