Individual
DR. TODD L FULCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MANHATTAN NURSING AND REHABILITATION CENTER, 4540 MANHATTAN RD, JACKSON, MS 39206
(601) 206-0901
(888) 240-6288
Mailing address
200 AMITY LN, BRANDON, MS 39047-7941
(601) 206-0901
(888) 240-6288
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12503
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00111649
—
MS
01
—
168390700
US DEPT OF LABOR
MS
01
—
4554283
AETNA
MS
01
—
75306815
MS HEALTH PARTNERS
MS
01
—
753068151
MS PHYSICIANS CARE NETWOR
MS
01
—
753068151002
TRICARE
MS
01
—
P00061664
RR MEDICARE
MS
Enumeration date
03/14/2006
Last updated
01/17/2022
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