DR. ELZER T. FULLER JR. (NPI# 1013961986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013961986 |
| Entity Type | Individual |
| Full Name | DR. ELZER T. FULLER JR. |
| Credential | M.D. |
| Practice Address |
969 Laurel Cove Rd London KY 40741-9024 |
| Practice Telephone | 6068432548 |
| Practice Fax Number | 8598730115 |
| Mailing Telephone | 6068432548 |
| Mailing Fax Number | 8598730115 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2014-01-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 19010 | KY | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | ME58598 | FL | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 19010 | KY | Allopathic & Osteopathic Physicians |
| Street Address |
969 LAUREL COVE RD |
| City | LONDON |
| State | KY |
| Zip Code | 40741-9024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841244 | Emily Anne Simmons | Pharmacist | 1851 West Hwy 192, London, KY 40741 | 2020-11-06 |
| 1871104364 | Jarrod Lee Napier | Optometrist | 103 Chera Lyn Ln, London, KY 40741 | 2020-08-10 |
| 1295378792 | Rebekah Virginia Elaine Cloud | Nurse Practitioner | 1649 Ky- 192 W, London, KY 40741 | 2019-10-28 |
| 1215416581 | Mary Jean Nolan | Nurse Practitioner | 1649 W. Hwy 192, London, KY 40741 | 2018-08-08 |
| 1558849620 | Pinnacle Treatment Centers Ky-1, LLC | Substance Abuse Rehabilitation Facility | 312 Carrera Drive, London, KY 40741 | 2018-08-01 |
| 1710463435 | Pinnacle Treatment Centers Ky-i, LLC | Substance Abuse Rehabilitation Facility | 300 Carrera Drive, London, KY 40741 | 2018-07-16 |
| 1720591076 | Hillary Clark | Nurse Practitioner | 192 London Shopping Ctr Ste 2, London, KY 40741 | 2017-11-08 |
| 1760901979 | Ariel Siler | Counselor | 454 N. Mcwhorter St., Suite 1, London, KY 40741 | 2017-09-19 |
| 1598287161 | Young Smiles,llc | Clinic/Center | 324 Holly Lane, London, KY 40741 | 2017-07-14 |
| 1952727505 | Renew Recovery, LLC | Substance Abuse Rehabilitation Facility | 2645 N Laurel Rd Ste B, London, KY 40741 | 2014-03-06 |
| Find all providers in zip 40741 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053792184 | James Thomas Watson | General Practice | 315 Louise Crt, London, ONTARIO N6G5G2 | 2015-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461171 | Christina Marie Shea Tobbe | General Practice | 1707 Cedar Grove Rd Ste 150, Shepherdsville, KY 40165-8572 | 2020-09-10 |
| 1689214454 | Superior Healthcare Pllc | General Practice | 7560 Us Highway 42 Ste B, Florence, KY 41042-1908 | 2020-01-09 |
| 1144876814 | You Only Live Once Medical | General Practice | 821 Ulrich Ave, Louisville, KY 40219-1844 | 2019-08-17 |
| 1760979124 | Healthy Living Primary Care | General Practice | 4400 Breckenridge Ln Ste 147, Louisville, KY 40218 | 2018-04-20 |
| 1649775586 | Landmark Medical of Kentucky, Psc | General Practice | 113 Glenn Pl Unit 100, Lexington, KY 40505-3518 | 2018-03-23 |
| 1639603145 | Charita Weathers | General Practice | 401 East Chestnut, Ste 610, Louisville, KY 40202 | 2017-04-12 |
| 1881146033 | Alliance Health Care, LLC | General Practice | 1710 D State Route 121 North, Murray, KY 42071 | 2016-11-03 |
| 1528519113 | A New Journey | General Practice | 4100 Cadillac Ct, Louisville, KY 40213-1591 | 2016-10-18 |
| 1013381441 | Veloz Medical Services Corp | General Practice | 6911 Shepherdsville Rd, Louisville, KY 40219-2211 | 2015-11-23 |
| 1407229545 | Fern Medical and Rehab Corp | General Practice | 5520 Fern Valley Rd, 107, Louisville, KY 40228-1087 | 2015-11-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.