NPI 1518620186

John Thomas Fuller, IDHS

Practitioner Independent Duty Corpsman Daphne, AL

Practice location

Address: 12239 Cressida Loop, Daphne, AL 36526-9001
Phone: (205) 901-4498

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1518620186
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Oct 2021
Record last updated: 20 Oct 2021

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.