Fuller, Jeffery

Fuller, Jeffery is an individual health care provider with primary practice located at 4864 Jackson St Department Of Emergency Medical Services, Monroe LA 71202-6400. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Fuller, Jeffery can be contacted via phone (318) 675-7737.

Contact Information

Primary practice address
4864 Jackson St Department Of Emergency Medical Services Monroe LA 71202-6400
Phone: (318) 675-7737
Fax: (318) 675-5666
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 018474 Louisiana

Profile Details

NPI number 1003827601
LBN Legal business name Fuller, Jeffery
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2006
Last updated Jul 8th, 2007 - about 17 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 1003827601 NPPES
Louisiana MEDICAID 1357723

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