Jonathan Ellis Fuller M.D.

NPI 1053314443 - Orthopaedic Surgery - 207XS0117X

NPI Details
NPI 1053314443
Gender Male
Enumeration Date 05/31/2005
Last Updated 01/28/2009
Entity Type Individual
Active Over 11 years ago
Practice Location
13616 CALIFORNIA ST
STE 100
OMAHA NE, 68154-5335, US
Phone (402) 496-0404
Fax (402) 496-0517
Business Location
13616 CALIFORNIA ST
STE 100
OMAHA NE, 68154-5335, US
Phone (402) 496-0404
Fax (402) 496-0517
Toxanomy
Taxonomy Code 207XS0117X
License State Nebraska
License Number 20813
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According to our database, Dr. Jonathan Ellis Fuller M.D. NPI is 1053314443, taxonomy code is 207XS0117X and license number is 20813, license state is located at Nebraska. Jonathan Ellis Fuller M.D. physically located at 13616 California St, Omaha NE, 68154-5335. NPI Number Jonathan Ellis Fuller M.D. has the Individual type.

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1053314443 NPI number is provided on an as is basis without warranty of any kind. 1053314443 is maintained by the National Plan & Provider Enumeration System. The contents of Jonathan Ellis Fuller M.D. are for informational purposes only.