Dr. Jonathan Ellis Fuller
Orthopaedic Spine Surgeon
13616 California St Ste 100
Omaha
, Nebraska 68154-5335
Dr. Jonathan Ellis Fuller
Orthopaedic Spine Surgeon
13616 California St Ste 100
Omaha
, Nebraska 68154-5335
(402) 496-0517
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About
Features
Specialties
- Orthopaedic Spine Surgeon
Languages spoken
- English
Location
First Address
- Dr. Jonathan Ellis Fuller
- 13616 California St Ste 100
- Omaha, NE
- Zip : 68154-5335
- Fax : (402) 496-0517
- Phone : (402) 496-0404
Second Address
- Dr. Jonathan Ellis Fuller
- 13616 California St Ste 100
- Omaha, NE
- Zip : 68154-5335
- Fax : (402) 496-0517
- Phone : (402) 496-0404
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XS0117X | Orthopaedic Spine Surgeon | 20813 | NE |
National Provider Identifier
| NPI | 1053314443 |
|---|---|
| Provider Name | Dr. Jonathan Ellis Fuller |
| First Address | Omaha, NE 68154-5335 |
| Second Address | Omaha, NE 68154-5335 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/05/2005 |
| Last Update Date | 28/01/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0511642 | (05) | IA |
| 07113 | BCBS (01) | NE |
| 200031840 | RAILROAD MEDICARE (01) | NE |
| 47081304012 | (05) | NE |
| F08923 | (02) | NE |
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.