| Mr John R Fuller, MD | |
|
500 Vincent St, Stevens Point, WI 54481-1842 | |
| (715) 295-9939 | |
| Not Available |
| Full Name | Mr John R Fuller |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Location | 500 Vincent St, Stevens Point, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801817267 | NPI | - | NPPES |
| P00069403 | Other | RAILROAD MEDICARE PROVIDER NUMBER | |
| 32166500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 36770020 (Wisconsin) | Primary |
| Entity Name | Aspirus Wausau Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922321140 PECOS PAC ID: 6406757442 Enrollment ID: O20040114000297 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr John R Fuller, MD 500 Vincent St, Stevens Point, WI 54481-1842 Ph: (715) 295-9939 | Mr John R Fuller, MD 500 Vincent St, Stevens Point, WI 54481-1842 Ph: (715) 295-9939 |
Kenneth E Sparr, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 824 Illinois Ave, Stevens Point, WI 54481 Phone: 715-342-7500 | |
Dr. Dustin Alan Pagoria, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 824 Illinois Ave, Stevens Point, WI 54481 Phone: 715-342-7500 | |
Chirasakdi Ratanawong, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 824 Illinois Ave, Stevens Point, WI 54481 Phone: 715-342-7500 |