DR. Jeryl Glynn Fullen, M.D.

NPI #1275631020 in Logansport, Indiana

Provider Information

NPI Number: 1275631020
Entity Type: Individual
Name: DR. Jeryl Glynn Fullen, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Orthopaedic Surgery
Credential: M.D.
Enumeration Date: Sep 20, 2006
Last Updated: Jan 16, 2014

Practice Location

Address: 1101 MICHIGAN AVE
City: Logansport
State: Indiana
ZIP Code: 46947-1528
Phone: (574) 753-1729

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthopaedic Surgery	207X00000X	Primary

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Organizations

Provider Name	Specialty	City
Northcentral Indana Orthopedics	Orthopaedic Surgery	Logansport	AI Deep Dive

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