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Individual

JOSEPH FULTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1200 MEMORIAL DRIVE, DALTON, GA 30720
(205) 977-1949
(706) 226-2283
Mailing address
3104 BLUE LAKE DRIVE, SUITE 110, BIRMINGHAM, AL 35243
(205) 977-1949
(205) 977-1933

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN110452
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000550756A
GA
Enumeration date
10/02/2006
Last updated
10/18/2021
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