Fullmer, Clark J

Fullmer, Clark J is an individual health care provider with primary practice located at 2615 Fairway St , Dickinson ND 58601. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Fullmer, Clark J can be contacted via phone (701) 456-6000.

Contact Information

Primary practice address
2615 Fairway St Dickinson ND 58601
Phone: (701) 456-6000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 60 North Dakota

Profile Details

NPI number 1649240557
LBN Legal business name Fullmer, Clark J
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2006
Last updated Aug 30th, 2018 - about 8 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 1649240557 NPPES
North Dakota MEDICAID 14953

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