Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JOSHUA R FULLMER, M.D.
ActiveOphthalmology · REXBURG, ID
Registration Details
- NPI Number
- 1447301395
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 16, 2007 (19.279027442257 yrs)
- Last Updated
- Jan 26, 2021
- License
-
M-9786 (ID)
Practice Information
- Address
-
23 SAWTELLE AVE STE 102REXBURG, ID, 834401499Browse ID providers · Browse ZIP 83440
- Phone
- 2083591888
- Fax
- 2083591889
- Primary Specialty
-
Ophthalmology
207W00000X
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.