Mark P Fuller, LCSW, SAC, ICS, is a
Social Worker - Clinical based in Keshena, Wisconsin. Mark P Fuller is licensed to practice in Wisconsin (license number 3082-123) and his current practice location is
W3275 Wolf River Road, Keshena, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(715) 799-5451.
NPI number for Mark P Fuller is 1780859744 and his current mailing address is Po Box 970, Keshena, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1780859744.
Healthcare Provider's Profile
| Full Name | Mark P Fuller |
|---|
| Gender | Male |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | W3275 Wolf River Road, Keshena, Wisconsin |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1780859744
- Provider Enumeration Date: 04/29/2008
- Last Update Date: 03/18/2016
Medical Identifiers
Medical identifiers for Mark P Fuller such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1780859744 | NPI | - | NPPES |
| 39691700 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 1041C0700X | Social Worker - Clinical | 3082-123 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mark P Fuller is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Mark P Fuller, LCSW, SAC, ICS, Po Box 970, Keshena, WI 54135-0970 Ph: (715) 799-5451 | Mark P Fuller, LCSW, SAC, ICS, W3275 Wolf River Road, Keshena, WI 54135 Ph: (715) 799-5451 |
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