Fulford, Randall B

Fulford, Randall B is an individual health care provider with primary practice located at 96279 Brady Point Rd , Fernandina Beach FL 32034-7076. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Fulford, Randall B can be contacted via phone (904) 321-0088.

Contact Information

Primary practice address
96279 Brady Point Rd Fernandina Beach FL 32034-7076
Phone: (904) 321-0088
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 004674 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA3183 Florida

Profile Details

NPI number 1295795896
LBN Legal business name Fulford, Randall B
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2006
Last updated Feb 1st, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295795896 NPPES
Georgia MEDICAID 100002029D
Georgia MEDICAID 100002029B
Georgia Other 01157676
Georgia MEDICAID 100002029C
Georgia MEDICAID 2909961-00

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