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Individual

JOHN GARY FULGENCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
116 PERSHING ST, LAFAYETTE, LA 70501-5038
(337) 739-2232
Mailing address
PO BOX 420, FRANKLIN, LA 70538-0420
(337) 739-2232

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
007143414
LA
347C00000X
Private Vehicle
Primary
007149414
LA

Other

Enumeration date
04/16/2025
Last updated
05/13/2025
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