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Individual
DR. JOHN BRYANT FULLER
Active
Individual
DR. JOHN BRYANT FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD2024-0084
NM
207XS0106X
Orthopaedic Hand Surgery Physician
ME155800
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD2024-0084
NM LICENSE
NM
Enumeration date
06/11/2015
Last updated
03/01/2024
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