Provider Demographics
NPI:1033672704
Name:FULTON, ZACHARY WILLIAM (DO)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:WILLIAM
Last Name:FULTON
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2409 CHERRY ST STE 10
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608-2625
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2409 CHERRY ST STE 10
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-2625
Practice Address - Country:US
Practice Address - Phone:419-251-6784
Practice Address - Fax:419-251-6787
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.017823207X00000X
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery