Fuller, Jason
Fuller, Jason is an sole proprietor health care provider with primary practice located at 1208 W Pleasure Ave , Searcy AR 72143-5151. He recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as his primary health care specialty. Fuller, Jason can be contacted via phone (501) 230-3916.Contact Information
Primary practice address
1208 W Pleasure Ave
Searcy AR 72143-5151
Phone: (501) 230-3916
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 1372 | Arkansas |
Profile Details
| NPI number | 1972718401 |
|---|---|
| LBN Legal business name | Fuller, Jason |
| Credentials | M.S. CCC-SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 10th, 2007 |
| Last updated | Jul 26th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972718401 | NPPES |
| Arkansas | Other | 5T864 | AR BLUECROSS BLUESHIELD |
| Arkansas | MEDICAID | 135025721 | AR BLUECROSS BLUESHIELD |
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