Organization
JOHN BRYANT FULLER MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN CLUKIE (ADMINISTRATOR)
(813) 997-2099
Entity
Organization
Contact information
Practice address
5145 DEER PARK DR, NEW PORT RICHEY, FL 34653-7013
(813) 997-2099
Mailing address
5145 DEER PARK DR, NEW PORT RICHEY, FL 34653-7013
(813) 997-2099
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
—
—
Other
Enumeration date
12/13/2023
Last updated
12/13/2023
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