Individual
BRIAN G. FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1775 THOMPSON RD, COOS BAY, OR 97420-2125
(541) 269-8520
(541) 267-5083
Mailing address
1775 THOMPSON RD, COOS BAY, OR 97420-2125
(541) 269-8520
(541) 267-5083
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
49432
CO
2085R0001X
Radiation Oncology Physician
Primary
MD186291
OR
2085R0001X
Radiation Oncology Physician
MD2023-0362
NM
Other
Enumeration date
10/12/2006
Last updated
12/27/2023
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