Provider Demographics
NPI:1730301920
Name:FULLERTON, LOUISE ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:ELIZABETH
Last Name:FULLERTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2 PIN OAK DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-4325
Mailing Address - Country:US
Mailing Address - Phone:303-972-8835
Mailing Address - Fax:303-972-8849
Practice Address - Street 1:2 PIN OAK DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-4325
Practice Address - Country:US
Practice Address - Phone:303-972-8835
Practice Address - Fax:303-972-8849
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO36593207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine