Ryan Mcculloch, PA

NPI 1720195530 · on the registry since 2006

Practice

Address: 147 W Chubbuck Rd
Chubbuck, ID 83202
Phone: (208) 238-7546
Fax: (208) 237-9643
Organisation at this address: Stoddard Medical, Inc
Idaho Skin Institute Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 5

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: 2010-12-20

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