Michael D. Fulford, PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

517 Issued in SC

Legal business name

MICHAEL D. FULFORD, PA

Practice address

304 Laurens St NW
Aiken, SC 29801-3997

Phone

(803) 649-9561

Fax

(803) 649-2664

NPI assigned

Dec 5, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael Dennis Fulford, OD

Title

President

Phone

(803) 649-9561

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336089600000",
    "number": "1154489573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 LAURENS ST NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298013997",
            "telephone_number": "803-649-9561",
            "fax_number": "803-649-2664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 LAURENS ST NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298013997",
            "telephone_number": "803-649-9561",
            "fax_number": "803-649-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D. FULFORD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2012-05-04",
        "status": "A",
        "authorized_official_last_name": "FULFORD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-649-9561",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "T250179184",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9643",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DS1538",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Ann Mentrup, PT
• Jaya Bindu Merugu, MD
• Isabelle Messer, LPN
• Theodore Mark Meyer, M.D.
• Mi'Angels Caretakers LLC
• Michelle Deirdre Arthur
• Midlands Prosthetics Adn Orthotics
• Charles David Miles, D.M.D.
• Eliza Miller
• Ellen E Miller, LPC LMFT NCDC

• Optometrist in Aiken, SC
• Providers in Aiken, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.