Individual provider · Type 1 NPI

Jonathan Fuller, PA

Medical Physician Assistant · Thomasville, GA

NPI number 1801229745 Active

Practice location

915 Gordon Ave, Rm 206208
Thomasville, GA 31792-6614

Mailing address

3560 W Pinetree Blvd
Thomasville, GA 31792-8822

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1801229745

Jonathan Fuller, PA's National Provider Identifier is 1801229745, issued on Aug 14, 2013. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Thomasville, GA. The record was last updated on Jun 13, 2019.