Individual
JULIUS TIMOTHY FULENWIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1075 JESSE JEWELL PKWY NE, STE B, GAINESVILLE, GA 30501-3814
(770) 536-5733
(770) 534-2114
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
(770) 219-8440
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
017181
GA
2086S0129X
Vascular Surgery Physician
Primary
017181
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00199086C
—
GA
Enumeration date
05/27/2005
Last updated
12/09/2015
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