Charles B Fuller (NPI# 1124015102, PAC ID# 5698731479) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1124015102 |
| PAC ID by PECOS | 5698731479 |
| Professional Enrollment ID | I20041203000151 |
| Full Name | Charles B Fuller |
| Organization Legal Name | FALLS AVENUE IMMEDIATE CARE PA |
| Address |
260 Falls Ave Suite D Twin Falls ID 83301-3370 |
| Phone Number | 2087336700 |
| Gender | M |
| Credential | PA |
| Graduation Year | 1997 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 6204172802 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 260 Falls Ave, Suite D, Twin Falls, ID 83301-3370 | 2087336700 | FALLS AVENUE IMMEDIATE CARE PA |
| Organization Legal Name | FALLS AVENUE IMMEDIATE CARE PA |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Walter S Rudeen | Undefined Physician Type (specify) | Falls Avenue Immediate Care Pa | 260 Falls Ave, Suite D, Twin Falls, ID 83301-3370 |
| Street Address |
260 FALLS AVE SUITE D |
| City | TWIN FALLS |
| State | ID |
| Zip | 83301-3370 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Walter S Rudeen | Undefined Physician Type (specify) | Falls Avenue Immediate Care Pa | 260 Falls Ave, Suite D, Twin Falls, ID 83301-3370 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John L Etcheto | Physician Assistant | Southern Idaho Pain Institute P.C. | 176 Falls Ave, Twin Falls, ID 83301-2306 |
| Daniel M Wettstein | Podiatry | 176 Falls Ave, Suite 200, Twin Falls, ID 83301-2306 | |
| Clinton L Dille | Anesthesiology | Southern Idaho Pain Institute P.C. | 176 Falls Ave, Twin Falls, ID 83301-2306 |
| Benjamin W Attebury | Physician Assistant | Southern Idaho Pain Institute P.C. | 176 Falls Ave, Twin Falls, ID 83301-2306 |
| Johnny M Urrutia | Physician Assistant | Southern Idaho Pain Institute P.C. | 176 Falls Ave, Twin Falls, ID 83301-2306 |
| Ronald E Mcgarrigle | Anesthesiology | St Luke's Clinic LLC | 450 Falls Ave, Suite 202, Twin Falls, ID 83301-2307 |
| Tammy L Emerson | Qualified Speech Language Pathologist | 450 Falls Ave, Twin Falls, ID 83301-2307 | |
| Todd G Hastings | Preventative Medicine | St Luke's Clinic LLC | 450 Falls Ave, Suite 202, Twin Falls, ID 83301-2307 |
| Thomas W Dirocco | Hospitalist | St Luke's Clinic LLC | 450 Falls Ave, Suite 202, Twin Falls, ID 83301-2307 |
| Mark J Edlund | Psychiatry | St Luke's Clinic LLC | 450 Falls Ave, Suite 202, Twin Falls, ID 83301-2307 |
| Find all physicians in zip 83301 | |||
| City | TWIN FALLS |
| Zip Code | 83301 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | TWIN FALLS + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Charles B 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.