Alvin R. Fulkerson
Dermatologist
1242 E Mckellips Rd Ste 103
Mesa
, Arizona 85203-2763
Alvin R. Fulkerson
Dermatologist
1242 E Mckellips Rd Ste 103
Mesa
, Arizona 85203-2763
(909) 557-1924
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About
Features
Specialties
- Dermatologist
Languages spoken
- English
Location
First Address
- Alvin R. Fulkerson
- 2285 Corporate Cir Ste 200
- Henderson, NV
- Zip : 89074-7759
- Fax : (909) 557-1924
- Phone : (702) 853-7450
Second Address
- Alvin R. Fulkerson
- 1242 E Mckellips Rd Ste 103
- Mesa, AZ
- Zip : 85203-2763
- Fax : (909) 557-1924
- Phone : (480) 962-4269
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | 14567 | AZ |
National Provider Identifier
| NPI | 1053368134 |
|---|---|
| Provider Name | Alvin R. Fulkerson |
| First Address | Henderson, NV 89074-7759 |
| Second Address | Mesa, AZ 85203-2763 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/05/2006 |
| Last Update Date | 13/09/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| C99504 | (02) | AZ |
| P00787594 | RR MEDICARE FOR CASA GRANDE (01) | AZ |
| Z130966 | (02) | AZ |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.