Individual
DR. DANIEL C FULMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2828 E MILLENNIUM PL, SUITE 2, FAYETTEVILLE, AR 72703-6514
(479) 582-1199
(479) 582-1194
Mailing address
2828 E MILLENNIUM PL, SUITE 2, FAYETTEVILLE, AR 72703-6514
(479) 582-1199
(479) 582-1194
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
155
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021200117
QUALCHOICE
AR
05
—
148310717
—
AR
01
—
155
BLUE CROSS
AR
05
—
200021680A
—
OK
01
—
5X002
BLUE SHIELD
AR
Enumeration date
07/10/2006
Last updated
11/10/2010
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