Fuller, Brian C

Fuller, Brian C is an individual health care provider with primary practice located at 2000 S Thompson St , Flagstaff AZ 86001-8759. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Fuller, Brian C can be contacted via phone (928) 226-6400.

Contact Information

Primary practice address
2000 S Thompson St Flagstaff AZ 86001-8759
Phone: (928) 226-6400
Fax: (928) 226-6411
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 3196 Arizona
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 3196 Arizona

Profile Details

NPI number 1174608772
LBN Legal business name Fuller, Brian C
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2006
Last updated Mar 30th, 2009 - about 15 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 1174608772 NPPES
Arizona MEDICAID 387953

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