Individual
DR. JONATHAN H FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1401 RAINBOW DR STE B, GADSDEN, AL 35901-5319
(256) 646-6358
(256) 467-3098
Mailing address
PO BOX 860, GADSDEN, AL 35902-0860
(256) 646-6358
(256) 467-3098
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
24416
MS
207Q00000X
Family Medicine Physician
Primary
DO.1762
AL
Other
Enumeration date
12/08/2014
Last updated
01/16/2018
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