John D Fulk, P.A.

NPI #1063419679 in Normal, Illinois

Provider Information

NPI Number: 1063419679
Entity Type: Individual
Name: John D Fulk, P.A.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: P.A.
Enumeration Date: Jun 29, 2005
Last Updated: Apr 4, 2019

Practice Location

Address: 1302 FRANKLIN AVE
Address 2: SUITE 4800
City: Normal
State: Illinois
ZIP Code: 61761-3551
Phone: (309) 454-5900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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