Individual
JEFFREY S FULFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
380 PLAINFIELD ST, SPRINGFIELD, MA 01199-0001
(413) 794-4458
(413) 794-9434
Mailing address
280 CHESTNUT ST, 2ND FLOOR, SPRINGFIELD, MA 01199-1000
(413) 794-5700
(413) 794-1629
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
79766
MA
Other
Enumeration date
07/25/2006
Last updated
07/08/2007
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