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Individual

JOSHUA R FULLMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
23 SAWTELLE AVE STE 102, REXBURG, ID 83440-1499
(208) 359-1888
(208) 359-1889
Mailing address
2100 PROVIDENCE WAY, IDAHO FALLS, ID 83404-4951
(208) 529-6600
(208) 529-6602

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M-9786
ID

Other

Enumeration date
01/16/2007
Last updated
01/26/2021
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