Individual
DR. JACK T. FULMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME12908
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10030
BLUE CROSS
FL
01
—
10030X
MEDICARE
FL
Enumeration date
12/11/2006
Last updated
09/24/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us