Fulton, Mark A

Fulton, Mark A is an individual health care provider with primary practice located at 1251 S Hickory St , Melbourne FL 32901-3221. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Fulton, Mark A can be contacted via phone (321) 434-3420.

Contact Information

Primary practice address
1251 S Hickory St Melbourne FL 32901-3221
Phone: (321) 434-3420
Fax: (321) 434-3423
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X ME105861 Florida

Profile Details

NPI number 1962409169
LBN Legal business name Fulton, Mark A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2005
Last updated Aug 31st, 2017 - about 9 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 1962409169 NPPES
Florida MEDICAID 001679400
Florida Other CS864X
Florida Other CS864Y

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