Provider Demographics
NPI:1023156734
Name:CULP, JEFFREY ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALAN
Last Name:CULP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:127 CRESTVIEW PARK DR STE 209
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2856
Mailing Address - Country:US
Mailing Address - Phone:615-446-5121
Mailing Address - Fax:615-446-1357
Practice Address - Street 1:127 CRESTVIEW PARK DR STE 205
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2856
Practice Address - Country:US
Practice Address - Phone:615-441-4500
Practice Address - Fax:615-908-1237
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2017-00916207RA0201X, 207RA0201X
TN53246207RA0201X
TNMD53246207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN53246OtherTENNESSEE MEDICAL LICENSE
IL036126551OtherILLINOIS MEDICAL LICENSE