Individual provider · Type 1 NPI

Keith Michael McCullough, PA-C

Physician Assistant · Coeur D Alene, ID

NPI number 1447800552 Active

Practice location

700 W Ironwood Dr Ste 175
Coeur D Alene, ID 83814-4401

Call (208) 625-6300 Map

Fax (208) 625-6301

Other practice locations

  • 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 · (208) 625-6360

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XPA-1818 (ID)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1447800552

Keith Michael McCullough, PA-C's National Provider Identifier is 1447800552, issued on Sep 19, 2019. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Coeur D Alene, ID. The record was last updated on Aug 3, 2025.