Provider Demographics
NPI:1033672704
Name:FULTON, ZACHARY WILLIAM (DO)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:WILLIAM
Last Name:FULTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:MERCY ST. VINCENT MEDICAL CENTER
Mailing Address - Street 2:2409 CHERRY ST., MOB 1, SUITE 10
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608
Mailing Address - Country:US
Mailing Address - Phone:419-251-6553
Mailing Address - Fax:419-251-9672
Practice Address - Street 1:MERCY ST. VINCENT MEDICAL CENTER
Practice Address - Street 2:2409 CHERRY ST., MOB 1, SUITE 10
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608
Practice Address - Country:US
Practice Address - Phone:419-251-6553
Practice Address - Fax:419-251-9672
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH58.030891207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery