Daniel G Fuller (NPI# 1023087632, PAC ID# 2860392842) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1023087632 |
| PAC ID by PECOS | 2860392842 |
| Professional Enrollment ID | I20040113000692 |
| Full Name | Daniel G Fuller |
| Organization Legal Name | SOUTHERN COLLEGE OF OPTOMETRY |
| Address |
1350 Concourse Ave Suite 264 Memphis TN 38104-2023 |
| Phone Number | 9012523670 |
| Gender | M |
| Credential | OD |
| Medical School | UNIVERSITY ALABAMA BIRMINGHAM - SCHOOL OF OPTOMETRY |
| Graduation Year | 1984 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 4587550454 |
| Number of Group Practice Members | 54 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1245 Madison Ave, Memphis, TN 38104-2211 | 9017223385 | SOUTHERN COLLEGE OF OPTOMETRY |
| 1350 Concourse Ave, Suite 264, Memphis, TN 38104-2023 | 9012523670 | SOUTHERN COLLEGE OF OPTOMETRY |
| Organization Legal Name | SOUTHERN COLLEGE OF OPTOMETRY |
| Physicians | 56 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shaleen Ragha | Optometry | Southern College of Optometry | 1245 Madison Ave, Memphis, TN 38104-2211 |
| Michael Christensen | Optometry | Southern College of Optometry | 1350 Concourse Ave, Suite 264, Memphis, TN 38104-2023 |
| Esla Subashi Speth | Optometry | Southern College of Optometry | 1245 Madison Ave, Memphis, TN 38104-2211 |
| Mary Hoang | Optometry | Southern College of Optometry | 1245 Madison Ave, Memphis, TN 38104-2211 |
| Cynthia Heard | Optometry | Southern College of Optometry | 1245 Madison Ave, Memphis, TN 38104-2211 |
| Darah Mcdaniel-chandler | Optometry | Southern College of Optometry | 1245 Madison Ave, Memphis, TN 38104-2211 |
| Gregory Wolfe | Optometry | Southern College of Optometry | 1350 Concourse Ave, Suite 264, Memphis, TN 38104-2023 |
| Lindsay Elkins | Optometry | Southern College of Optometry | 1245 Madison Ave, Memphis, TN 38104-2211 |
| Michael Dorkowski | Optometry | Southern College of Optometry | 1245 Madison Ave, Memphis, TN 38104-2211 |
| Kristina Haworth | Optometry | Southern College of Optometry | 1350 Concourse Ave, Suite 264, Memphis, TN 38104-2023 |
| Street Address |
1350 CONCOURSE AVE SUITE 264 |
| City | MEMPHIS |
| State | TN |
| Zip | 38104-2023 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Christensen | Optometry | Southern College of Optometry | 1350 Concourse Ave, Suite 264, Memphis, TN 38104-2023 |
| Gregory Wolfe | Optometry | Southern College of Optometry | 1350 Concourse Ave, Suite 264, Memphis, TN 38104-2023 |
| Kristina Haworth | Optometry | Southern College of Optometry | 1350 Concourse Ave, Suite 264, Memphis, TN 38104-2023 |
| Rachel Grant | Optometry | Southern College of Optometry | 1350 Concourse Ave, Suite 264, Memphis, TN 38104-2023 |
| Reena Lepine | Optometry | Southern College of Optometry | 1350 Concourse Ave, Suite 264, Memphis, TN 38104-2023 |
| Constance Victoria Simpson | Nurse Practitioner | Msk Group PC | 1350 Concourse Ave, Suite 363, Memphis, TN 38104-2023 |
| Susan F Nelson | Family Medicine | Church Health Center of Memphis Inc | 1350 Concourse Ave, Suite 142, Memphis, TN 38104-2020 |
| David Keith Jennings | Internal Medicine | Church Health Center of Memphis Inc | 1350 Concourse Ave, Suite 142, Memphis, TN 38104-2020 |
| Sheila M Thomas | Family Medicine | Church Health Center of Memphis Inc | 1350 Concourse Ave, Suite 142, Memphis, TN 38104-2020 |
| Aditee S Satpute | Family Medicine | Church Health Center of Memphis Inc | 1350 Concourse Ave, Suite 142, Memphis, TN 38104-2020 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Banjul L Covington | Nurse Practitioner | Church Health Center of Memphis Inc | 1350 Concourse Ave, Suite 142, Memphis, TN 38104-2020 |
| Sharon L Thorpe | Nurse Practitioner | Church Health Center of Memphis Inc | 1350 Concourse Ave, Suite 142, Memphis, TN 38104-2020 |
| Glenn Scott Morris | Family Medicine | Church Health Center of Memphis Inc | 1350 Concourse Ave, Suite 142, Memphis, TN 38104-2020 |
| Melissa Jean Fullerton | Family Medicine | Church Health Center of Memphis Inc | 1350 Concourse Ave, Suite 142, Memphis, TN 38104-2020 |
| Tammy L Carnahan | Nurse Practitioner | Church Health Center of Memphis Inc | 1350 Concourse Ave, Suite 142, Memphis, TN 38104-2020 |
| Cory Scott Heinkel | Physical Therapy | Msk Group PC | 1350 Concourse Ave, Suite 363, Memphis, TN 38104-2023 |
| Stephen M Wetick | Optometry | Southern College of Optometry | 1350 Concourse Ave, Suite 264, Memphis, TN 38104-2023 |
| Wilson Walter Mcgriff | Optometry | Southern College of Optometry | 1350 Concourse Ave, Suite 264, Memphis, TN 38104-2023 |
| Jennifer D James | Chiropractic | Msk Group PC | 1350 Concourse Ave, Suite 363, Memphis, TN 38104-2023 |
| Brian Knight | Optometry | Southern College of Optometry | 1350 Concourse Ave, Suite 264, Memphis, TN 38104-2023 |
| Find all physicians in zip 38104 | |||
| City | MEMPHIS |
| Zip Code | 38104 |
| Specialty | OPTOMETRY |
| City + Specialty | MEMPHIS + OPTOMETRY |
Please comment or provide details below to improve the information on Daniel G Fuller.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.