Individual
MARCUS JEVON FULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NREMT-B
Contact information
Practice address
964 WINTER GARDEN DR UNIT 1, SHREVEPORT, LA 71107-3129
(318) 221-0467
Mailing address
964 WINTER GARDEN DR UNIT 1, SHREVEPORT, LA 71107-3129
(318) 221-0467
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
B1595888
LA
Other
Enumeration date
03/14/2008
Last updated
03/14/2008
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