WILLIAM ALLEN FULLER JR. (NPI# 1225006489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225006489 |
| Entity Type | Individual |
| Full Name | WILLIAM ALLEN FULLER JR. |
| Credential | MD |
| Practice Address |
2212 Wilborn Ave South Boston VA 24592-1630 |
| Practice Telephone | 4345728921 |
| Practice Fax Number | 4345722063 |
| Mailing Telephone | 4345728921 |
| Mailing Fax Number | 4345722063 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 0101023878 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | OPTIMA | 16829 | 01 |
| VA | BCBS | 003685 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710146931 | William Fuller | Social Worker | 242 N Magdalen St, San Angelo, TX 76903-5434 | 2008-06-03 |
| 1164631750 | William S Fuller | Social Worker | 1501 N Pierce St, Suite 105, Little Rock, AR 72207-5203 | 2007-05-21 |
| 1205323177 | William Tyler Fuller | Internal Medicine | 2500 N State St, Jackson, MS 39216 | 2018-04-17 |
| 1326440488 | William Mills Fuller | Physician Assistant | 11700 W 2nd Pl Ste 350, Lakewood, CO 80228-1710 | 2014-09-20 |
| 1780092973 | William Liddell Fuller | Internal Medicine | 800 Rose St, Lexington, KY 40536-0001 | 2014-07-31 |
| 1952721490 | William Scott Fuller | Internal Medicine | 622 W 168th St, New York, NY 10032-3720 | 2014-04-23 |
| 1437415189 | William Allen Fuller | Counselor | 4240 Auburn Way N, Auburn, WA 98002-1311 | 2012-04-06 |
| 1487821690 | William Shaw Fuller | Marriage & Family Therapist | 101 S B St, Lompoc, CA 93436-6933 | 2008-05-15 |
| 1588621478 | William Edward Fuller | Obstetrics & Gynecology | 1601 E 19th Ave, Suite 5100, Denver, CO 80218-1216 | 2006-04-26 |
| 1518939024 | William C Fuller | Psychiatry & Neurology | 4400 W 69th St, Ste 1500, Sioux Falls, SD 57108-8170 | 2006-02-07 |
| Street Address |
2212 WILBORN AVE |
| City | SOUTH BOSTON |
| State | VA |
| Zip Code | 24592-1630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861472524 | Nonna Lyn M Ebalo | Pediatrics | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2006-01-19 |
| 1366814113 | Fuller Roberts Ob-gyn and Primary Care | Obstetrics & Gynecology | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2015-10-20 |
| 1316320187 | Cynthia Blanks Cole | Nurse Practitioner | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2015-06-29 |
| 1255771770 | Dominion Health Medical Assoc. | Clinic/Center | 2212 Wilborn Ave, South Boston, VA 24592 | 2013-06-28 |
| 1346553468 | Michelle Wilkens Helms | Specialist | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2010-07-18 |
| 1659317576 | Duc K Trieu | Obstetrics & Gynecology | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2006-06-20 |
| 1407891815 | Fuller-roberts Clinic, Inc | Pediatrics | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2006-06-19 |
| 1932178019 | Pamela Reynolds | Nurse Practitioner | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2006-03-14 |
| 1124097282 | Joan Wilson | Obstetrics & Gynecology | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2006-03-14 |
| 1427026806 | Prasit Thanaporn | Obstetrics & Gynecology | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2006-03-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966398 | Transformations Center for Health Wellness LLC | Counselor | 2170 Sandy Beach Road, South Boston, VA 24592 | 2019-11-12 |
| 1740830215 | Kirstyn Lokker | Occupational Therapist | 1 High School Circle, South Boston, South Boston, VA 24592 | 2019-09-17 |
| 1841764248 | Nicole Ivey | Occupational Therapy Assistant | 103 Rosehil Rd, South Boston, VA 24592 | 2019-01-18 |
| 1841700960 | Bio-medical Applications of Virginia, Inc. | Clinic/Center | 130 Aubreys Loop, South Boston, VA 24592 | 2017-10-03 |
| 1659828820 | Family Preservation Services, Inc | Community/Behavioral Health | 1 High School Circle, South Boston, VA 24592 | 2016-09-06 |
| 1316222821 | Family and Children Enrichment Services Inc. | Health Maintenance Organization | 220 Paradise Lane, South Boston, VA 24592 | 2011-10-15 |
| 1326365578 | Brinda Howard | Nurse's Aide | 104 Love Shop Park Rd Lot #25, South Boston, VA 24592 | 2010-04-28 |
| 1356513543 | Betts Medical Supplies, LLC. | Durable Medical Equipment & Medical Supplies | 403 Factory Street, Suite B, South Boston, VA 24592 | 2008-03-27 |
| 1407051873 | Dominion Health Medical Assoc | Legal Medicine | 101 Aubrey's Loop Rd, South Boston, VA 24592 | 2007-06-18 |
| 1437352945 | Behavioral Health Associates, Inc. | Non-emergency Medical Transport (VAN) | 515 Yancey Ave, South Boston, VA 24592 | 2007-06-11 |
| Find all providers in zip 24592 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497717177 | Surgical Associates of South Boston Inc | Surgery | 2206a Wilborn Ave, South Boston, VA 24592 | 2006-04-06 |
| 1811996648 | Edward Sanford Purvis II | Surgery | 2232 Wilborn Avenue, Physicians Pavilion, South Boston, VA 24592-2936 | 2005-07-14 |
| 1205141819 | Sameer Salah Alrefai | Surgery | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2010-08-09 |
| 1225044035 | Gurnam S Bajwa | Surgery | 2206a Wilborn Ave, South Boston, VA 24592 | 2006-08-01 |
| 1407824527 | Lovetta Pugh | Surgery | 2232 Wilborn Ave, South Boston, VA 24592-1630 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740819911 | Charles W Hurt | Surgery | 195 Riverbend Dr Ste 1, Charlottesville, VA 22911-8708 | 2020-04-08 |
| 1720616261 | Katherine Maria Barrows | Surgery | 3300 Gallows Rd, Dept of Surgery, Falls Church, VA 22042-3307 | 2020-03-30 |
| 1891202412 | Valley Physician Enterprise, Inc. | Surgery | 1870 Amherst St Ste 2a, Winchester, VA 22601-2841 | 2018-01-04 |
| 1508388554 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Surgery | 5875 Bremo Rd Ste 110, Richmond, VA 23226-1934 | 2017-07-12 |
| 1457729048 | Donnarose Klemovitch | Surgery | 11226 Goldflower Ct, Fairfax Station, VA 22039-2026 | 2015-09-13 |
| 1114303922 | Loudoun Medical Group PC | Surgery | 19415 Deerfield Ave Ste 213, Lansdowne, VA 20176-8471 | 2015-08-04 |
| 1255728374 | Malinda Lyon | Surgery | 8150 Shore Drive, #522, Norfolk, VA 23518 | 2015-04-16 |
| 1760877377 | Caleb Luke Cutherell | Surgery | 2900 Lamb Cir Ste 302, Christiansburg, VA 24073-6341 | 2015-03-31 |
| 1457745143 | Dwayne North | Surgery | 7554 Hospital Dr Ste D303, Gloucester, VA 23061-4178 | 2015-03-20 |
| 1720479504 | Affinity Healthcare Group LLC | Surgery | 3356 Western Branch Blvd, #f, Chesapeake, VA 23321-5138 | 2015-02-14 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BOSTON |
| Zip Code | 24592 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.