NPI 1053314443

Jonathan Ellis Fuller, MD

Practitioner Orthopaedic Surgery of the Spine Physician Omaha, NE

Practice location

Address: 13616 California St STE 100, Omaha, NE 68154-5335
Phone: (402) 496-0404
Fax: (402) 496-0517

Registered specialties

Orthopaedic Surgery of the Spine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207XS0117X Licence 20813 (NE)

Other Orthopaedic Surgery providers in Nebraska →

Registry record

NPI: 1053314443
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 May 2005
Record last updated: 28 Jan 2009

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.