Individual
DR. RANDY FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
100 N ACADEMY AVE, GMC, DIVISION OF PSYCHIATRY, DANVILLE, PA 17822-1335
(570) 271-6516
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS017826
PA
103G00000X
Clinical Neuropsychologist
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Other
Enumeration date
09/18/2013
Last updated
08/19/2020
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