Individual
DR. WAYNE B FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
210 2ND AVE SE, CULLMAN, AL 35055-3514
(256) 734-1121
(256) 734-1991
Mailing address
210 2ND AVE SE, P. O. BOX 1067, CULLMAN, AL 35055-3514
(256) 734-1121
(256) 734-1991
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S320TA285
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51521397
BCBS
AL
Enumeration date
10/06/2006
Last updated
07/08/2007
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