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Individual

MR. DONALD J FULKERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
2600 NAVARRE AVE, OREGON, OH 43616-3207
(419) 696-7595
Mailing address
809 MAIN ST, GENOA, OH 43430-1637
(419) 855-4091

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03216683
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
360081
OH
Enumeration date
06/14/2021
Last updated
06/14/2021
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