KYLE ALAN MCCULLOUGH MD NPI 1043743479

NPI Information

  • NPI: 1043743479
  • Provider Name: KYLE ALAN MCCULLOUGH, MD
  • Classification: Student in an Organized Health Care Education/Training Program - 390200000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 263 FARMINGTON AVE
    FARMINGTON, CT
    ZIP 06030
  • Phone: (860) 679-1411

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NPI Details

Kyle Alan Mccullough, MD is a student in an organized health care education training program in Farmington, CT with 9 years of experience. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Kyle Alan Mccullough, MD NPI is 1043743479. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

263 FARMINGTON AVE
FARMINGTON, CT
ZIP 06030-921
Phone: (860) 679-1411

The NPI 1043743479 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/4/2017 and was last updated on 11/2/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208600000XSurgeryU5754TEXASNo
2390200000XStudent in an Organized Health Care Education/Training Program81585CONNECTICUTYes
32086S0102XSurgerySurgical Critical CareU5754TEXASNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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