Fuller, Gregory W

Fuller, Gregory W is an individual health care provider with primary practice located at 1006 Airport Rd , Jackson MI 49202-1851. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Fuller, Gregory W can be contacted via phone (517) 784-6663.

Contact Information

Primary practice address
1006 Airport Rd Jackson MI 49202-1851
Phone: (517) 784-6663
Fax: (517) 787-7976
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 012543 Michigan
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS5478 Florida
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 5101012543 Michigan

Profile Details

NPI number 1174569107
LBN Legal business name Fuller, Gregory W
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2006
Last updated Sep 23rd, 2021 - about 4 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 1174569107 NPPES
Michigan MEDICAID 114545400
Michigan Other GF012543

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