| John Fuller, MD | |
| 1000 E Cherry St, Troy, MO 63379-1513 | |
| (636) 528-8551 | |
| Not Available | 
| Full Name | John Fuller | 
|---|---|
| Gender | Male | 
| Speciality | Emergency Medicine | 
| Location | 1000 E Cherry St, Troy, Missouri | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1093754574 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207P00000X | Emergency Medicine | 112096 (Missouri) | Primary | 
| Entity Name | Mercy Hospital South | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1568481984 PECOS PAC ID: 8426962556 Enrollment ID: O20031113000592 | 
| Entity Name | Southeastern Emergency Physicians Of Memphis Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1437105277 PECOS PAC ID: 5395643209 Enrollment ID: O20060711000434 | 
| Entity Name | Cep America Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1619332046 PECOS PAC ID: 6608056171 Enrollment ID: O20150312000325 | 
| Entity Name | Mercy Hospital Lincoln | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1962808733 PECOS PAC ID: 5193040020 Enrollment ID: O20150623002541 | 
| Entity Name | Mercy Aco Clinical Services Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1063965093 PECOS PAC ID: 6901188572 Enrollment ID: O20170117001888 | 
| Mailing Address | Practice Location Address | 
|---|---|
| John Fuller, MD 10010 Kennerly Rd, Saint Louis, MO 63128-2106 Ph: (314) 525-1900 | John Fuller, MD 1000 E Cherry St, Troy, MO 63379-1513 Ph: (636) 528-8551 | 
| Timothy Mccullough, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1000 E Cherry St, Troy, MO 63379 Phone: 636-528-3221 | |
| Pamela Westerling, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 230 Tompkins Court, Troy, MO 63379 Phone: 708-422-4221 Fax: 708-422-4415 |