George H Fuller, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

016330 Issued in LA

Practice address

4630 Ambassador Caffery Pkwy
Ste 208
Lafayette, LA 70508-6949

Phone

(337) 981-6100

Fax

(337) 988-8751

NPI assigned

Jul 7, 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

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Louisiana State University School of Medicine in Shreveport, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Imaging Clinic, LLCGroup PAC ID 9234290925, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• La Imaging Clinic, LLC

  • Speech-Language Pathologist
  • Alexandria, LA
  • NPI 1568628972
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1992703649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4809 AMBASSADOR CAFFERY PKWY",
            "address_2": "SUITE 200",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086917",
            "telephone_number": "337-981-6100",
            "fax_number": "337-988-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 AMBASSADOR CAFFERY PKWY",
            "address_2": "STE 208",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086949",
            "telephone_number": "337-981-6100",
            "fax_number": "337-988-8751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "GEORGE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "LA",
            "license": "016330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA - RAILROAD M",
            "identifier": "160019227",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1348783",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryce Fugarino, M.D.
• Darah L Fugetta, DDS
• Juan M Fukuda, M.D.
• John Gary Fulgence
• Full Spectrum ABA of Louisiana
• Heather Fuller, MSW, LCSW
• Leighanna R Fulton, MS, LPC
• Fallon Funderburk, BSN, RN, CNOR, RNFA
• Natalie Wright Funderburk, CRNA
• Hazel M Fuselier, SOCIAL WORKER

• Obstetrics & Gynecology Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Obstetrics & Gynecology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.