Fuller, Leta R
Fuller, Leta R is an individual health care provider with primary practice located at 4401 Harrison Blvd , Ogden UT 84403-3195. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as her primary health care specialty. Fuller, Leta R can be contacted via phone (801) 387-4300.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 6000865-1205 | Utah |
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 35073246 | Ohio |
Profile Details
| NPI number | 1982696159 |
|---|---|
| LBN Legal business name | Fuller, Leta R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 16th, 2005 |
| Last updated | May 19th, 2024 - about last year |
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 | 1982696159 | NPPES |
| Ohio | MEDICAID | 2140178 | |
| Ohio | MEDICAID | 64060502 |
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