Individual
DR. JOSEPH CARDWELL FULLER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10700 E GEDDES AVE STE 200, ENGLEWOOD, CO 80112-3861
(303) 761-9190
(720) 874-4462
Mailing address
10700 E GEDDES AVE STE 200, ENGLEWOOD, CO 80112-3861
(303) 761-9190
(720) 874-4462
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
04-39828
KS
2085R0202X
Diagnostic Radiology Physician
2016-01080
NC
2085R0202X
Diagnostic Radiology Physician
29941
NE
2085R0202X
Diagnostic Radiology Physician
Primary
58155
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111257106
MEDICARE PIN
KS
05
—
1811287816
—
CO
01
—
581760YQ33
MEDICARE PIN
CO
01
—
581760YQN9
MEDICARE PIN
CO
01
—
581760YQPG
MEDICARE PIN
CO
01
—
581760ZLJ3
MEDICARE PIN
CO
01
—
581760ZNTB
MEDICARE PIN
CO
01
—
KA3249097
MEDICARE PIN
KS
01
—
NA1214119
MEDICARE PIN
NE
01
—
NA1215120
MEDICARE PIN
NE
01
—
NA1217018
MEDICARE PIN
NE
Enumeration date
04/11/2011
Last updated
06/27/2025
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