Cory Mccullough

NPI 1093630600 · on the registry since 2026

Practice

Address: 330 E Benton St
Pocatello, ID 83201
Phone: (208) 233-0651
Fax: (208) 478-1731
Organisation at this address: Albertsons Llc
1918 Winter Street Operating Co Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 6

Registry record

Primary taxonomy: 183700000X
183700000X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2026-08-12

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho