Organization
JOSHUA R FULLMER MD PLLC
Active
Organization
JOSHUA R FULLMER MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZZETTE THATCHER (BUSINESS MANAGER)
(208) 359-1888
Entity
Organization
Contact information
Practice address
381 E 4TH N STE 100, REXBURG, ID 83440-1684
(208) 359-1888
Mailing address
381 E 4TH N STE 100, REXBURG, ID 83440-1684
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M-9786
ID
Other
Enumeration date
07/20/2007
Last updated
07/20/2007
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