Michael J Fullerton, O.D.

NPI #1215071949 in Pryor, Oklahoma

Provider Information

NPI Number: 1215071949
Entity Type: Individual
Name: Michael J Fullerton, O.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Feb 16, 2007
Last Updated: Mar 25, 2009

Practice Location

Address: 202 S ADAIR ST
City: Pryor
State: Oklahoma
ZIP Code: 74361-5202
Phone: (918) 825-0055

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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