Individual
ROBERT B FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 SHIRCLIFF WAY, JACKSONVILLE, FL 32204-4748
(904) 308-7300
(419) 866-5453
Mailing address
PO BOX 863026, ORLANDO, FL 32866-3026
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME0048483
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11183
BCBS
FL
05
—
255502600
—
FL
01
—
P00084729
RAILROAD MEDICARE
FL
Enumeration date
06/25/2006
Last updated
04/19/2013
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