Individual
DR. GENE R FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
999 MURRAY HOLLADAY RD, SUITE 207, SALT LAKE CITY, UT 84117-4901
(801) 268-2584
(801) 262-1168
Mailing address
7181 S CAMPUS VIEW DR STE 200, WEST JORDAN, UT 84084-4312
(801) 965-3600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1786161205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870573947004
—
UT
Enumeration date
02/22/2006
Last updated
10/18/2022
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