Gary Trent Fullmer is a Surgical in Phoenix, Arizona. Gary Trent Fullmer practices all healthcare services and medical treatments related to Surgical. The NPI Number for Gary Trent Fullmer is 1427008150. The last update date is 2023-03-07.
Gary Trent Fullmer's current location address is 3030 N Central Ave Ste 1001, Phoenix, Arizona. You can contact this provider via phone number 6024064786 and fax number 9166364358. The mailing address for Gary Trent Fullmer is 3030 N Central Ave Ste 1001, Phoenix, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gary Trent Fullmer |
|---|---|
| Address | 3030 N Central Ave Ste 1001, Phoenix, Arizona |
| Phone Number | 6024064786 |
| Fax Number | 9166364358 |
| Sole Proprietor | Y |
| Credentials | P.A.-C |
NPI Number Detail
| NPI Number | 1427008150 |
|---|---|
| Provider Enumeration Date | 2006-05-11 |
| Last Updated Date | 2023-03-07 |
Provider Mailing Address Detail
| Address | 3030 N Central Ave Ste 1001 |
|---|---|
| City | Phoenix |
| State | Arizona (AZ) |
| Post Code | 850122716 |
| Phone Number | 6024064786 |
| Fax Number | 9166364358 |
Provider's Primary Taxonomy Detail
| Speciality | Surgical |
|---|---|
| Taxonomy | 363As0400X |
| Licence No | 2774 |
|
Definition: A licensed healthcare professional who assists in providing surgical care under physician supervision. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2774 | AZ | PHYSICIAN ASSISTANT LICEN |
Post Comment/ Review Below
What is the unique provider identifier assigned to Gary Trent Fullmer?
The Gary Trent Fullmer has been issued the NPI (National Provider Identifier) 1427008150 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Gary Trent Fullmer?
The Gary Trent Fullmer is physically situated at 3030 N Central Ave Ste 1001, in the city of Phoenix, state of AZ, with the postal code 850122716.
What is Gary Trent Fullmer's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Gary Trent Fullmer is Surgical, and the corresponding taxonomy classification code for this specialized field is 363As0400X.
On what date did the Centers for Medicare & Medicaid Services assign the 1427008150 to Gary Trent Fullmer?
The Centers for Medicare & Medicaid Services assigned the 1427008150 to Gary Trent Fullmer on 2006-05-11.
When was the information pertaining to Gary Trent Fullmer most recently updated or revised?
The details related to Gary Trent Fullmer, including its address, specialty, and other relevant information, were last updated or revised on 2023-03-07.