Individual
SPENCER FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
5449 RENO CORPORATE DR STE 200, RENO, NV 89511-2626
(775) 737-9411
(775) 737-9413
Mailing address
5449 RENO CORPORATE DR STE 200, RENO, NV 89511-2626
(775) 737-9411
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2018020280
MO
207W00000X
Ophthalmology Physician
12685949-1205
UT
207W00000X
Ophthalmology Physician
2018020280
MO
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
24889
NV
Other
Enumeration date
06/25/2018
Last updated
08/16/2024
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