Individual
ZACHARY BENNETT FULKERSON
Active
Individual
ZACHARY BENNETT FULKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD., PHD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01076478A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
01076478A
IN
207RP1001X
Pulmonary Disease Physician
01076478A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001275067
ANTHEM PTAN
IN
05
—
300025978
—
IN
Enumeration date
05/17/2013
Last updated
03/07/2025
Update your record
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