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Individual

JOHN P FULKERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
800 HOWARD AVE, NEW HAVEN, CT 06519-1369
(877) 925-3637
Mailing address
47 COLLEGE ST FL 2, NEW HAVEN, CT 06510-3209
(203) 785-6610

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
017855
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001178557
CT
Enumeration date
07/01/2005
Last updated
09/02/2020
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