Individual
RANDY CURTIS FULLERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2021 CHURCH ST, SUITE 504, NASHVILLE, TN 37203-2021
(615) 284-7900
(615) 284-3488
Mailing address
9235 COXBORO CT, BRENTWOOD, TN 37027-7435
(615) 661-5283
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16963
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105694
—
TN
Enumeration date
12/03/2005
Last updated
07/08/2007
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