Fuller, Nelson Jackson

Fuller, Nelson Jackson is an sole proprietor health care provider with primary practice located at 503 Constitution Dr , Iuka MS 38852-8201. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Fuller, Nelson Jackson can be contacted via phone (662) 424-9500.

Contact Information

Primary practice address
503 Constitution Dr Iuka MS 38852-8201
Fax: (662) 424-9592
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X PTA4006 Mississippi

Profile Details

NPI number 1609913276
LBN Legal business name Fuller, Nelson Jackson
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 31st, 2007
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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