Individual
DR. TIMOTHY MICHAEL FULLAGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 MED TECH PKWY, SUITE 300, JOHNSON CITY, TN 37604-2365
(423) 232-8301
(423) 232-8304
Mailing address
701 MED TECH PKWY, SUITE 300, JOHNSON CITY, TN 37604
(423) 232-8301
(423) 232-8304
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
41401
TN
Other
Enumeration date
08/08/2006
Last updated
09/28/2011
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