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

DR. JERYL GLYNN FULLEN, M.D.

Active

DR. JERYL GLYNN FULLEN, M.D. is a Orthopaedic Surgery healthcare provider located in LOGANSPORT, Indiana. NPI 1275631020 is currently active in the NPPES registry. Verify at CMS.

Orthopaedic Surgery · LOGANSPORT, IN

Registration Details

NPI Number
1275631020
Provider Type
Individual
Gender
Male
NPI Issued
Sep 20, 2006 (19.927321973151 yrs)
Last Updated
Jan 16, 2014
Licenses
04-16478 (KS)
01063517A (IN)

Practice Information

Address
1101 MICHIGAN AVE
LOGANSPORT, IN, 469471528
Browse IN providers · Browse ZIP 46947
Phone
5747531729
Primary Specialty
Orthopaedic Surgery
207X00000X
Additional Specialty
Orthopaedic Surgery

Other Orthopaedic Surgery Providers in LOGANSPORT, IN

Name Credential NPI
DR. JAMES R DAVIS DO 1811958804
KRAL VARHAN MD 1235147919
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.