NPI 1003199233

Johnathan T Fuller, PHARMD

Practitioner Pharmacist Owensboro, KY

Practice location

Address: 2318 Frederica St, Owensboro, KY 42301-4826
Phone: (270) 686-7873
Fax: (270) 686-7864

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 015034 (KY)

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Registry record

NPI: 1003199233
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Sep 2011
Record last updated: 23 Sep 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.