Provider Demographics
NPI:1285628750
Name:MCCULLY, FRANCIS R JR (MD)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:R
Last Name:MCCULLY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 LAUREL AVE # N304
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-1810
Mailing Address - Country:US
Mailing Address - Phone:865-766-6870
Mailing Address - Fax:865-766-0133
Practice Address - Street 1:1468 HILLTOP RD
Practice Address - Street 2:
Practice Address - City:CHESTER SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:19425-2808
Practice Address - Country:US
Practice Address - Phone:865-766-6870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD055767L2085R0202X
CAG886322085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0071574400002Medicaid
PA1285628750OtherRAILROAD MEDICARE
PA50084014OtherCAPITAL BLUE CROSS
PA685363OtherBLUE SHIELD
PA0071574400002Medicaid
PA50084014OtherCAPITAL BLUE CROSS