Dr. Elzer T. Fuller Jr., M.D.
General Practice in London, KY. Individual provider (NPI-1).
NPI number1013961986
StatusActive
Last updated in NPPESJan 13, 2014
Details
- NPI
- 1013961986
- Entity type
- Individual (NPI-1)
- Name
- Dr. Elzer T. Fuller Jr.
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 22, 2006
- Last updated
- Jan 13, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | 19010 | KY | Yes |
| 207P00000X | Emergency Medicine | ME58598 | FL | |
| 207P00000X | Emergency Medicine | 19010 | KY |
Practice location
969 Laurel Cove RdLondon, KY 40741-9024
Phone 606-843-2548 · Fax 859-873-0115
Mailing address
969 Laurel Cove RdLondon, KY 40741-9024
Phone 606-843-2548 · Fax 859-873-0115
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