Individual
THOMAS SCOTT FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA-C
Contact information
Practice address
650 WOOD VALLEY TRCE, ROSWELL, GA 30076-2672
(404) 683-0907
Mailing address
650 WOOD VALLEY TRCE, ROSWELL, GA 30076
(404) 683-0907
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
1574
GA
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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