Individual
DANIEL W. FULTS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0100
(801) 581-6908
(801) 581-4385
Mailing address
PO BOX 413030, SALT LAKE CITY, UT 84141-3050
(801) 213-3900
(801) 585-3655
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
175971-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396835997
—
UT
Enumeration date
10/13/2006
Last updated
09/15/2014
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