NPI 1043776925

Darryl McCullough

Practitioner Driver Jackson, MS

Practice location

Address: 5842 N Dale St, Jackson, MS 39211-3331
Phone: (601) 906-0520

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 800490647 (MS)

Other Driver providers in Mississippi →

Registry record

NPI: 1043776925
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Feb 2019
Record last updated: 15 Feb 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.