Provider Demographics
NPI:1144525684
Name:CULPEPPER, GEORGE WALLACE (NRP, CCEMT-P, FP-C)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:WALLACE
Last Name:CULPEPPER
Suffix:
Gender:M
Credentials:NRP, CCEMT-P, FP-C
Other - Prefix:
Other - First Name:G.
Other - Middle Name:WALLACE
Other - Last Name:CULPEPPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NRP, CCEMT-P, FP-C
Mailing Address - Street 1:1546 FITZPATRICK RD
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36092-3729
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6600 VAN AALST BLVD
Practice Address - Street 2:
Practice Address - City:FORT BENNING
Practice Address - State:GA
Practice Address - Zip Code:31905-2102
Practice Address - Country:US
Practice Address - Phone:762-408-2140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-13
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9700560146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic