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Individual

DR. JAMES H FULLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
15761 NEW HAMPSHIRE CT, FORT MYERS, FL 33908-4176
(239) 415-8377
(239) 415-8770
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING AND RELATIONS, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME12279
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051414400
FL
01
102044
AVMED
FL
01
16628
BCBS OF FL
FL
01
2524858
CIGNA
FL
01
4237105
AETNA
FL
01
P01283315
RAILROAD MCR
FL
01
P107611
FREEDOM HEALTH
FL
01
P952479
OPTIMUM
FL
Enumeration date
02/21/2006
Last updated
09/10/2014
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