Fullmer, Gary Trent
Fullmer, Gary Trent is an sole proprietor health care provider with primary practice located at 485 S Dobson Rd Ste 110 , Chandler AZ 85224. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Fullmer, Gary Trent can be contacted via phone (480) 728-4470.Contact Information
Primary practice address
485 S Dobson Rd Ste 110
Chandler AZ 85224
Phone: (480) 728-4470
Fax: (480) 728-4499
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 2774 | Arizona |
Profile Details
| NPI number | 1427008150 |
|---|---|
| LBN Legal business name | Fullmer, Gary Trent |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 11th, 2006 |
| Last updated | Mar 7th, 2023 - about 2 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 | 1427008150 | NPPES |
| Arizona | Other | 2774 | PHYSICIAN ASSISTANT LICEN |
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