Richard L Fuller, D.O.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

34. 001836 Issued in OH

Practice address

3545 Lincoln Way E
Suite a
Massillon, OH 44646-8624

Phone

(330) 837-5191

Fax

(330) 837-0755

NPI assigned

Sep 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1376537506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 LINCOLN WAY E",
            "address_2": "SUITE A",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446468624",
            "telephone_number": "330-837-5191",
            "fax_number": "330-837-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 LINCOLN WAY E",
            "address_2": "SUITE A",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446468624",
            "telephone_number": "330-837-5191",
            "fax_number": "330-837-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "RICHARD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "34. 001836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0199459",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180019148",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan L Frank, RN
• Franklin Milos Frazier
• Sandra Diane Frazier, RN
• Tara Frazier
• Kimberly Ann Freborg, OTR
• Olivia Funk
• Sarah Beth Funk, M.D.
• Shabbir T Garbadawala, MD
• Marcy Sue Garrott, PT
• Jessica Gasber

• Ophthalmology Physician in Massillon, OH
• Providers in Massillon, OH by specialty
• Ophthalmology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.