Individual
DR. STANLEY R FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
116 MINNIE ST, FAIRBANKS, AK 99701-3006
(907) 456-7760
(907) 328-1867
Mailing address
116 MINNIE ST, FAIRBANKS, AK 99701-3006
(907) 456-7760
(907) 328-1867
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
100664
AK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2011
Last updated
11/29/2016
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