Kevin S Fuller in Fairfax - Physician Assistant
Kevin S Fuller - NPI 1417119652
Kevin S Fuller is a Physician Assistant in Fairfax, Virginia. Kevin S Fuller practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Kevin S Fuller is 1417119652. The last update date is 2021-04-21.
Kevin S Fuller's current location address is 13135 Lee Jackson Memorial Hwy Ste 305, Fairfax, Virginia. You can contact this provider via phone number 7033598640 and fax number 7035916105. The mailing address for Kevin S Fuller is 13135 Lee Jackson Memorial Hwy Ste 305, Fairfax, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kevin S Fuller |
|---|---|
| Address | 13135 Lee Jackson Memorial Hwy Ste 305, Fairfax, Virginia |
| Phone Number | 7033598640 |
| Fax Number | 7035916105 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1417119652 |
|---|---|
| Provider Enumeration Date | 2008-06-30 |
| Last Updated Date | 2021-04-21 |
Provider Mailing Address Detail
| Address | 13135 Lee Jackson Memorial Hwy Ste 305 |
|---|---|
| City | Fairfax |
| State | Virginia (VA) |
| Post Code | 220331907 |
| Phone Number | 7033598640 |
| Fax Number | 7035916105 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 110001208 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 110001208 | VA | LICENSE NUMBER | |
| 1417119652 | VA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Kevin S Fuller by the Centers for Medicare & Medicaid Services?
The Kevin S Fuller has been assigned the NPI (National Provider Identifier) 1417119652. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Kevin S Fuller?
The Kevin S Fuller is physically situated at 13135 Lee Jackson Memorial Hwy Ste 305, in the city of Fairfax, state of VA, with the postal code 220331907.
What is the area of specialization for Kevin S Fuller, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Kevin S Fuller is Physician Assistant, and the corresponding taxonomy code that categorizes this area of expertise is 363A00000X.
On what date did Kevin S Fuller receive its 1417119652 assignment from the Centers for Medicare & Medicaid Services?
The Kevin S Fuller was assigned its 1417119652 on 2008-06-30, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information pertaining to Kevin S Fuller most recently updated or revised?
The details related to Kevin S Fuller, including its address, specialty, and other relevant information, were last updated or revised on 2021-04-21.
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