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David A. Fullenkamp,od, Pc
Eyewear Supplier in Portland, Indiana
NPI 1235457862

David A. Fullenkamp,od, Pc is a Eyewear Supplier based in Portland, IN. David A. Fullenkamp,od, Pc practices in Portland, IN. The NPI Number for David A. Fullenkamp,od, Pc is 1235457862 and holds a License No. 18002167A (Indiana).

The current practice location address for David A. Fullenkamp,od, Pc is 1111 N Meridian St, Portland, IN and can be reached out via phone at 260-726-4210 and via fax at 260-726-9347.

Location: 1111 N Meridian St, Portland, IN, 47371-1024
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1235457862
Provider Name
David A. Fullenkamp,od, Pc
Credential
Provider Entity Type
Organization
Address
1111 N Meridian St, Portland, IN, 47371-1024
Phone Number
260-726-4210
Fax Number
260-726-9347
Provider Enumeration Date
05/06/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100424160A 05 IN
0207200002 01 IN PTAN
institution
Provider Business Practice Location Address Details
Address
1111 N Meridian St
City
Portland
State
Indiana
Zip
47371-1024
Phone Number
260-726-4210
Fax Number
260-726-9347
person
Provider Business Mailing Address Details
Address
1111 N Meridian St
City
Portland
State
Indiana
Zip
47371-1024
Phone Number
260-726-4210
Fax Number
260-726-9347
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Eyewear Supplier
Speciality
-
Taxonomy
332H00000X
License No.
18002167A (Indiana)
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
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