Douglas Lamar Fillmore, PA

NPI #1447341193 in Provo, Utah

Provider Information

NPI Number: 1447341193
Entity Type: Individual
Name: Douglas Lamar Fillmore, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Sep 27, 2006
Last Updated: Oct 15, 2007

Practice Location

Address: 1055 N 500 W
Address 2: SUITE 121
City: Provo
State: Utah
ZIP Code: 84604-3305
Phone: (801) 373-7350

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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