Individual provider · Type 1 NPI

Timothy Richard Fullam, MD

Neuromuscular Medicine (Psychiatry & Neurology) Physician · Phoenix, AZ

NPI number 1952720104 Active

Practice location

240 W Thomas Rd # 400
Phoenix, AZ 85013-4407

Call (602) 406-6262 Map

Fax (602) 406-6261

Mailing address

240 W Thomas Rd Ste 301
Phoenix, AZ 85013-4407

Other practice locations

301 Fisher Street, 81 Mdos/sgomu, Keesler Afb, MS 39564 · (228) 376-5378
3551 Roger Brooke Dr, Jbsa Fort Sam Houston, TX 78234-4504 · (210) 916-2203

Specialties and licenses

Taxonomy	Code	License
Neuromuscular Medicine (Psychiatry & Neurology) Physician	2084N0008X	T1068 (TX)
Neurology Physician	2084N0400X	T1068 (TX)
General Practice Physician	208D00000X	28833 (NE)
Neuromuscular Medicine (Psychiatry & Neurology) Physician Primary	2084N0008X	73815 (AZ)

Neuromuscular Medicine (Psychiatry & Neurology) Physician: A neurologist or child neurologist who specializes in the diagnosis and management of disorders of nerve, muscle or neuromuscular junction, including amyotrophic lateral sclerosis, peripheral neuropathies (e.g., diabetic and immune mediated neuropathies), various muscular dystrophies, congenital and acquired myopathies, inflammatory myopathies (e.g., polymyositis, inclusion body myositis) and neuromuscular transmiss…

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About NPI 1952720104

Timothy Richard Fullam, MD's National Provider Identifier is 1952720104, issued on Apr 15, 2014. The primary taxonomy on file is Neuromuscular Medicine (Psychiatry & Neurology) Physician (2084N0008X), and the practice location is in Phoenix, AZ. The record was last updated on Feb 5, 2025.