JONATHAN FULLER PA NPI 1801229745

NPI Information

  • NPI: 1801229745
  • Provider Name: JONATHAN FULLER, PA
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 915 GORDON AVE
    RM 206208
    THOMASVILLE, GA
    ZIP 31792
  • Phone: (229) 228-2799

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NPI Details

Jonathan Fuller, PA is a medical physician assistant in Thomasville, GA. Jonathan Fuller, PA NPI is 1801229745. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

915 GORDON AVE
RM 206208
THOMASVILLE, GA
ZIP 31792-614
Phone: (229) 228-2799

The NPI 1801229745 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/14/2013 and was last updated on 6/13/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician AssistantNo
2363AM0700XPhysician AssistantMedicalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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