Fuller, Jon D
Fuller, Jon D is an individual health care provider with primary practice located at 7 Shackleford West Blvd , Little Rock AR 72211-3886. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Fuller, Jon D can be contacted via phone (501) 664-5860.Contact Information
Primary practice address
7 Shackleford West Blvd
Little Rock AR 72211-3886
Phone: (501) 664-5860
Fax: (501) 664-0889
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | E4323 | Arkansas |
Profile Details
| NPI number | 1225080765 |
|---|---|
| LBN Legal business name | Fuller, Jon D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 16th, 2006 |
| Last updated | Oct 30th, 2018 - about 7 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 | 1225080765 | NPPES |
| Arkansas | MEDICAID | 158312001 |
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