Fuller, John R
Fuller, John R is an individual health care provider with primary practice located at 500 Vincent St , Stevens Point WI 54481-1842. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Fuller, John R can be contacted via phone (715) 295-9939.Contact Information
Primary practice address
500 Vincent St
Stevens Point WI 54481-1842
Phone: (715) 295-9939
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 36770020 | Wisconsin |
Profile Details
| NPI number | 1801817267 |
|---|---|
| LBN Legal business name | Fuller, John R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2006 |
| Last updated | Dec 29th, 2021 - about 3 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 | 1801817267 | NPPES |
| Other | P00069403 | RAILROAD MEDICARE PROVIDER NUMBER | |
| MEDICAID | 32166500 | RAILROAD MEDICARE PROVIDER NUMBER |
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