Fullman, Jeffrey D
Fullman, Jeffrey D is an individual health care provider with primary practice located at 19250 Sw 65Th Ave Ste 110, Tualatin OR 97062-7452. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Fullman, Jeffrey D can be contacted via phone (503) 692-1205.Contact Information
Primary practice address
19250 Sw 65Th Ave Ste 110
Tualatin OR 97062-7452
Phone: (503) 692-1205
Fax: (503) 692-1207
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD13393 | Oregon |
Profile Details
| NPI number | 1932178951 |
|---|---|
| LBN Legal business name | Fullman, Jeffrey D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 14th, 2006 |
| Last updated | Jul 19th, 2010 - about 16 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 | 1932178951 | NPPES |
| Oregon | MEDICAID | 282301 |
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