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Larry Chad Fuller, STUDENT
Diagnostic Radiology Physician in Gainesville, Florida
NPI 1912360421

Larry Chad Fuller is a Diagnostic Radiology Physician based in Gainesville, FL and is specialized in Diagnostic Radiology. Larry Chad Fuller practices in Gainesville, FL and has the professional credentials of STUDENT. The NPI Number for Larry Chad Fuller is 1912360421 and holds a License No. (Florida).

The current practice location address for Larry Chad Fuller is 1600 Sw Archer Rd, Gainesville, FL and can be reached out via phone at 352-265-0291.

Location: 1600 Sw Archer Rd, Gainesville, FL, 32610-0374
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1912360421
Provider Name
Larry Chad Fuller
Credential
STUDENT
Provider Entity Type
Individual
Gender
Male
Address
1600 Sw Archer Rd, Gainesville, FL, 32610-0374
Phone Number
352-265-0291
Fax Number
Provider Enumeration Date
04/01/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
110846200 05 FL
institution
Provider Business Practice Location Address Details
Address
1600 Sw Archer Rd
City
Gainesville
State
Florida
Zip
32610-2360
Phone Number
352-265-0291
Fax Number
person
Provider Business Mailing Address Details
Address
1600 Sw Archer Rd
City
Gainesville
State
Florida
Zip
32610-2360
Phone Number
352-265-0291
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
OS17722 (Florida)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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