Fuller, Wayne B

Fuller, Wayne B is an sole proprietor health care provider with primary practice located at 210 2Nd Ave Se , Cullman AL 35055-3514. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Fuller, Wayne B can be contacted via phone (256) 734-1121.

Contact Information

Primary practice address
210 2Nd Ave Se Cullman AL 35055-3514
Fax: (256) 734-1991
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X S320TA285 Alabama

Profile Details

NPI number 1689761041
LBN Legal business name Fuller, Wayne B
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 6th, 2006
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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Identifiers

StateTypeNumberIssuer
All States NPI 1689761041 NPPES
Alabama Other 51521397 BCBS

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