| Doctor Name: | MR. BARNEY MCCOLLOUGH |
| NPI Number: | 1053579128 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A. |
| License Number: | PA2646 |
| Business Practice Address: | 5915 W Gulf To Lake Hwy Crystal River, FL - 344297565 |
| Business Phone Number: | 3527943872 |
| Business Fax Number: | 3527943876 |
| Mailing Address: | 315 N Pompeo Ave, CRYSTAL RIVER |
| State: | FL |
| Postal Code: | 344297911 |
| Phone Number: | 3526130689 |
| Fax Number: | 3527943876 |
| NPI Enumeration Date: | 05/27/2008 |
| NPI Last Update Date: | 12/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA2646 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |