Individual
DR. RICHARD L FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3545 LINCOLN WAY E, SUITE A, MASSILLON, OH 44646-8624
(330) 837-5191
(330) 837-0755
Mailing address
3545 LINCOLN WAY E, SUITE A, MASSILLON, OH 44646-8624
(330) 837-5191
(330) 837-0755
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
34. 001836
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0199459
—
OH
01
—
180019148
RAILROAD MEDICARE
OH
Enumeration date
09/02/2005
Last updated
06/27/2012
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