SearchIdahoPhysician Assistant

Keith Mccullough, PA-C

NPI 1447800552 · on the registry since 2019

Practice

Address
700 W Ironwood Dr Ste 175
Coeur D Alene, ID 83814
Phone
(208) 625-6300
Fax
(208) 625-6301
Organisation at this address
Element Dental Pllc
Ideal Family Dental
Kootenai Health, Inc.
Kootenai Health, Inc.
Interlake Pharmacy Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
189

Additional practice sites

  • 2003 Kootenai Health Way, Coeur D Alene, ID

Registry record

Primary taxonomy
Physician Assistant
363A00000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-08-03

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