Daniel W. Fults III, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

175971-1205 Issued in UT

Practice address

50 N Medical Dr
Salt Lake City, UT 84132-0100

Phone

(801) 581-6908

Fax

(801) 581-4385

NPI assigned

Oct 13, 2006

Last updated

Sep 15, 2014By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Neuroscience

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Salt Lake City, UT
  • NPI 1225135106
  NPD (past)
• University Neurosurgery Associates

  • Neurological Surgery Physician
  • Salt Lake City, UT
  • NPI 1942306972
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1396835997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413030",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841413050",
            "telephone_number": "801-213-3900",
            "fax_number": "801-585-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320100",
            "telephone_number": "801-581-6908",
            "fax_number": "801-581-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTS",
        "first_name": "DANIEL",
        "middle_name": "W.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "UT",
            "license": "175971-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396835997",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John B Fulton, PHD
• Krysten Fulton
• Sarah Fulton
• Skylar Fulton
• William Fulton, LCSW
• Amanda Christine Hess Funaki
• Functionally Integrative Therapy LLC
• Camille Manyan Fung, MD
• Christopher Funk, DPM
• Deborah Gay Funk

• Neurological Surgery Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Neurological Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; 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.