Fuller, Adam K
Fuller, Adam K is an individual health care provider with primary practice located at 191 Overthrust Rd , Evanston WY 82930-9261. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Fuller, Adam K can be contacted via phone (435) 631-9918.Contact Information
Primary practice address
191 Overthrust Rd
Evanston WY 82930-9261
Phone: (435) 631-9918
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 306 | Wyoming |
Profile Details
| NPI number | 1255476131 |
|---|---|
| LBN Legal business name | Fuller, Adam K |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 20th, 2007 |
| Last updated | Mar 29th, 2018 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255476131 | NPPES |
| Wyoming | MEDICAID | 118774100 |
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