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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 IncInferred 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