Provider Demographics
NPI:1548286792
Name:CULBERTSON, JOE CAMPBELL (MD)
Entity type:Individual
Prefix:DR
First Name:JOE
Middle Name:CAMPBELL
Last Name:CULBERTSON
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 742353
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:630 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-4908
Practice Address - Country:US
Practice Address - Phone:801-299-3781
Practice Address - Fax:801-299-2416
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT160794-12052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry