Provider Demographics
NPI:1447390257
Name:FULPER, JAMES CHARLES (MD MRO)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CHARLES
Last Name:FULPER
Suffix:
Gender:M
Credentials:MD MRO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 NW 11TH ST
Mailing Address - Street 2:SUITE E33
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838
Mailing Address - Country:US
Mailing Address - Phone:541-567-2600
Mailing Address - Fax:541-567-2690
Practice Address - Street 1:600 NW 11TH ST
Practice Address - Street 2:SUITE E33
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838
Practice Address - Country:US
Practice Address - Phone:541-567-2600
Practice Address - Fax:541-567-2690
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD131182083X0100X
WAMD195732083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AFI648885OtherDEA