Fuller, Jeremy D
Fuller, Jeremy D is an individual health care provider with primary practice located at 1340 Hal Greer Blvd , Huntington WV 25701-3804. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Fuller, Jeremy D can be contacted via phone (304) 526-2200.Contact Information
Primary practice address
1340 Hal Greer Blvd
Huntington WV 25701-3804
Phone: (304) 526-2200
Fax: (304) 399-6726
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 21688 | West Virginia |
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | TP578 | Kentucky |
Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 21688 | West Virginia |
Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 21688 | West Virginia |
Profile Details
NPI number | 1285713156 |
---|---|
LBN Legal business name | Fuller, Jeremy D |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 3rd, 2006 |
Last updated | Mar 7th, 2023 - about 2 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 | 1285713156 | NPPES |
Kentucky | MEDICAID | 7100048840 | |
Kentucky | MEDICAID | 1285713156 | |
Kentucky | MEDICAID | 2783519 |
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