Fuller, Ronald

Fuller, Ronald is an individual health care provider with primary practice located at 1970 E 53Rd St , Davenport IA 52807-2710. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Fuller, Ronald can be contacted via phone (563) 359-3949.

Contact Information

Primary practice address
1970 E 53Rd St Davenport IA 52807-2710
Phone: (563) 359-3949
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 32081 Iowa

Profile Details

NPI number 1932169893
LBN Legal business name Fuller, Ronald
Credentials M.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated May 5th, 2021 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932169893 NPPES
Iowa Other 1187187 MEDICAID IOWA W/ ORA
Iowa Other K51666 MEDICAID IOWA W/ ORA
Iowa Other 20765 MEDICAID IOWA W/ ORA
Iowa MEDICAID 4187487 MEDICAID IOWA W/ ORA
Iowa Other 300121312 MEDICAID IOWA W/ ORA
Iowa Other 32985 MEDICAID IOWA W/ ORA
Iowa Other 300095837 MEDICAID IOWA W/ ORA
Iowa Other 20765 MEDICAID IOWA W/ ORA
Iowa Other 300132299 MEDICAID IOWA W/ ORA
Iowa Other 49669 MEDICAID IOWA W/ ORA
Iowa MEDICAID 0187187 MEDICAID IOWA W/ ORA

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