Individual
DR. RICHARD EUSTIS FULTON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1556 WELLINGTON AVE, GRAND JUNCTION, CO 81501-8233
(970) 241-4406
Mailing address
1556 WELLINGTON AVE, GRAND JUNCTION, CO 81501-8233
(970) 241-4406
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
17480
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17480
STATE LICENSE NUMBER
CO
Enumeration date
02/06/2011
Last updated
02/06/2011
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