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Individual

HAROLD JONES FULLER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
391 SERPENTINE DR, SUITE 400, SPARTANBURG, SC 29303-3096
(864) 560-7517
(864) 560-7520
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2001-01044
NC
2084P0800X
Psychiatry Physician
Primary
38586
SC
2084P0805X
Geriatric Psychiatry Physician
200101044
NC
2084P0805X
Geriatric Psychiatry Physician
38586
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1376578252
NC
05
891307G
NC
05
N0104H
SC
01
P01564416
RAILROAD MEDICARE
SC
Enumeration date
07/11/2006
Last updated
03/03/2023
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