Individual
JEFFREY A FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
320 E NORTH AVE, PITTSBURGH, PA 15212-4756
(412) 359-6656
(412) 359-6653
Mailing address
320 E NORTH AVE, PITTSBURGH, PA 15212-4756
(412) 359-6656
(412) 359-6653
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
OS007677L
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
34.009093
OH
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
OS007677L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001809908
—
PA
01
—
10927102
CAQH
—
05
—
2754649
—
OH
Enumeration date
08/14/2006
Last updated
11/15/2023
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