MR. MARK THERON FULTON


Address: 4500 Stuart St, Mach Credentials, Columbia, SC 29207-5700
Phone: 8037516634

MR. MARK THERON FULTON (NPI# 1235234170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1235234170
Entity Type Individual
Full Name MR. MARK THERON FULTON
Credential PA-C
Practice Address 4500 Stuart St
Mach Credentials
Columbia
SC 29207-5700
Mailing Address 2 Angus Rd
Columbia
SC 29223-7745
Practice Telephone 8037516634
Mailing Telephone 8038659794
Enumeration Date 2006-09-14
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant 1032992 Physician Assistants & Advanced Practice Nursing Providers

Other Providers MARK FULTON

NPI Name Taxonomy Address Enumeration
1992725998 Mark Fulton Dentist 3482 State Road 9 North, Anderson, IN 46012 2006-07-20
1962409169 Mark A Fulton Neurological Surgery 1251 S Hickory St, Melbourne, FL 32901-3221 2005-07-01
1386648020 Mark A Fulton Pharmacist 3210 Banksville Rd, Pittsburgh, PA 15216-2757 2005-06-10
1528125085 Mark K Fulton Psychiatry & Neurology 123 Andover Rd, Westbrook, ME 04092-3848 2007-01-03
1700848074 Mark J. Fulton Psychologist 35 E Elizabeth Ave, Bethlehem, PA 18018-6505 2006-04-03

Office Location

Street Address 4500 STUART ST
MACH CREDENTIALS
City COLUMBIA
State SC
Zip Code 29207-5700

Providers in the same location

NPI Name Taxonomy Address Enumeration
1912505231 Christopher Michael Enke Occupational Therapist 4500 Stuart St, Columbia, SC 29207-5700 2020-10-09
1366071144 Kaitlin Chrastek Specialist/Technologist 4500 Stuart St, Columbia, SC 29207-5700 2020-04-03
1316582455 Melissa Angela Metivier Physical Therapist 4500 Stuart St, Columbia, SC 29207-5700 2019-11-13
1952954695 Jeriann Sandrik Optometrist 4500 Stuart St, Columbia, SC 29207 2019-07-22
1669946455 Tonya Yvette Parks Counselor 4500 Stuart St, Columbia, SC 29207-5700 2019-01-15
1538653795 Jennifer L Willard Licensed Practical Nurse 4500 Stuart St, Columbia, SC 29207-5700 2018-06-20
1114469475 Carrie Elizabeth Green Physical Therapist 4500 Stuart St, Columbia, SC 29207-5700 2016-11-17
1841640489 Daniel Greathouse Optometrist 4500 Stuart St, 3rd Floor Clinic Wing, Columbia, SC 29207-5700 2016-06-14
1356796205 Rajesh Devkota Nurse Practitioner 4500 Stuart St, Columbia, SC 29207-5700 2016-04-28
1114385770 Garry Dredge Physical Therapist 4500 Stuart St, Columbia, SC 29207-5700 2016-02-10
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1265043756 Steven Mariani Rodriguez Dentist 5330 Moseby Street, Columbia, SC 29207 2020-08-10
1568082493 Nichole Eckrich Dentist 5330 Moseby St., Columbia, SC 29207 2020-04-21
1730733007 Forrest Wane Fullenkamp Student in an Organized Health Care Education/Training Program 5330 Moseby St, Columbia, SC 29207 2019-07-25
1306401625 Kayla Anne Wolcott Pharmacist Moncrief Army Hospital Outpatient Pharmacy 1 Ft Jackson, Columbia, SC 29207 2019-05-02
1588145098 Renetta Denise Green Counselor Fort Jackson/acs 9810 Lee St, Columbia, SC 29207 2018-08-23
1154814028 Amanda Zelnick Dentist Bldg 5330 Moseby St, Ft Jackson, NC 29207 2018-06-14
1790231777 Brittaney Elizabeth Anne Lewelling Specialist/Technologist 5975 Chesnut Road, Columbia, SC 29207 2016-08-30
1376749838 Moncrief Army Community Hospital Clinic/Center 5330 Mosby Street, Fort Jackson, SC 29207 2007-06-22
1902002462 Moncrief Army Community Hospital Clinic/Center 1890 Washington Road, Fort Jackson, SC 29207 2007-06-22
1730279860 Donna L Briquet Pharmacist 4500 Marion Street, Columbia, SC 29207 2006-10-12
Find all providers in zip 29207

Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1619500691 Ivanka M Mora Physician Assistant 5910 Watch Chain Way Apt 603, Columbia, MD 21044-3875 2020-02-18
1316579287 Christina Verzi Physician Assistant 5681 Columbia Rd Apt 301, Columbia, MD 21044-1960 2020-02-10
1225668064 Steven Ebers Physician Assistant 1201 International Dr, Columbia, MO 65202-1612 2020-01-21
1780228197 Jeremy M Barth Physician Assistant 5886 Morningbird Ln, Columbia, MD 21045-3508 2019-10-30
1730749920 Ann Marie Schlafly Physician Assistant 1 Hospital Drive, Mc 413, Columbia, MO 65212-0001 2019-06-19
1619532363 Casey Burner Skinner Physician Assistant 2126 Tugaloo Ave, Columbia, SC 29205-3330 2019-05-08
1205491040 Meghan Catherine Monk Physician Assistant 229 Route 87, Columbia, CT 06237-1050 2019-05-07
1124594999 Candace Rachel Skulkety Physician Assistant 612 Whaley St Apt 348, Columbia, SC 29201-6329 2018-10-19
1508346396 Hannah Marie Dewes Physician Assistant 3 Medical Park Rd #310, Columbia, SC 29203 2018-08-21
1295236438 Helen Mckinney Physician Assistant 234 Castlebury Dr, Columbia, SC 29229-7566 2018-02-22
Find all providers in COLUMBIA

Competitor

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City COLUMBIA
Zip Code 29207

Improve Information

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Dataset Information

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.

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