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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DAVID A FULLENKAMP, O.D.

Active

DAVID A FULLENKAMP, O.D. is a Optometrist healthcare provider located in PORTLAND, Indiana. NPI 1043297625 is currently active in the NPPES registry. Verify at CMS.

Optometrist · PORTLAND, IN

Registration Details

NPI Number
1043297625
Provider Type
Individual
Gender
Male
NPI Issued
Dec 27, 2005 (20.61566199059 yrs)
Last Updated
Nov 24, 2009
License
18002167A (IN)

Practice Information

Address
1111 N MERIDIAN ST
PORTLAND, IN, 473711024
Browse IN providers · Browse ZIP 47371
Phone
2607264210
Fax
2607269347
Primary Specialty
Optometrist
152W00000X

Other Optometrist Providers in PORTLAND, IN

Name Credential NPI
DR. ABBY ELIZABETH SMALL OD 1457975484
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.