Organization
FULLERTON MEDICAL GROUP
Active
Organization
FULLERTON MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY FULLERTON M.D. (GENERAL PARTNER)
(615) 284-7900
Entity
Organization
Contact information
Practice address
2021 CHURCH ST, SUITE 504, NASHVILLE, TN 37203-2021
(615) 284-7900
(615) 284-3488
Mailing address
2021 CHURCH ST, SUITE 504, NASHVILLE, TN 37203-2021
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105694
—
TN
Enumeration date
01/14/2006
Last updated
08/22/2020
Update your record
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