Individual provider · Type 1 NPI

Lori A. McCullough, PA-C

Medical Physician Assistant · Belleville, IL

NPI number 1336312693 Active

Practice location

4500 Memorial Dr
Belleville, IL 62226-5360

Call (618) 257-6220 Map

Mailing address

6400 Clayton Rd, Ste 110
St. Louis, MO 63117-1850

Other practice locations

  • 6400 Clayton Rd, Ste 110, St. Louis, MO 63117-1850 · (314) 645-4434
  • 1711 W Highway 50, O Fallon, IL 62269-1681 · (618) 206-5076

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700X2002001000 (MO)
Medical Physician Assistant Primary 363AM0700X085005433 (IL)

Medical Physician Assistant: Definition to come...

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About NPI 1336312693

Lori A. McCullough, PA-C's National Provider Identifier is 1336312693, issued on Apr 8, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Belleville, IL. The record was last updated on Aug 31, 2022.