Timothy Fuller, MD

Vascular Surgery Physician · Tifton, GA

Individual Active NPI

NPI number 1104153063

Practice location

1641 Madison Ave
Tifton, GA 31794-3757
Phone
(229) 353-2284

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NPI record

NPI
1104153063
Entity type
Individual (Type 1)
Enumeration date
November 12, 2009
Last updated
January 30, 2024
Certified
January 30, 2024
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Vascular Surgery Physician Primary 2086S0129X 085351 GA
Surgery Physician 208600000X MED-PHYS-LIC-103773 MT
Student in an Organized Health Care Education/Training Program 390200000X — —
Surgery Physician 208600000X 085351 GA
Vascular Surgery Physician 2086S0129X MED-PHYS-LIC-103773 MT

Mailing address

907 18TH St E Ste 400
Tifton, GA 31794-3684
Phone
(229) 353-3422

Other practice locations (1)

  • 1333 Surgical Services Way, Kalispell, MT 59901-4844 · (406) 751-5392

About Dr. Fuller

Timothy Fuller, MD is a healthcare provider registered in the NPI registry with the primary taxonomy Vascular Surgery Physician (code 2086S0129X). The practice location is 1641 Madison Ave, Tifton, GA 31794-3757. The NPI number 1104153063 was assigned on November 12, 2009 and the record was last updated on January 30, 2024.

Dr. Fuller lists 4 licenses in the registry: #085351 (GA) for Vascular Surgery Physician; #MED-PHYS-LIC-103773 (MT) for Surgery Physician; #085351 (GA) for Surgery Physician; #MED-PHYS-LIC-103773 (MT) for Vascular Surgery Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Timothy Fuller, MD?

The NPI number is 1104153063.

What is the phone number of Dr. Fuller?

The phone number listed for the practice location is (229) 353-2284.

Where is Dr. Fuller located?

1641 Madison Ave, Tifton, GA 31794-3757.

What is the taxonomy code for Dr. Fuller?

The primary taxonomy code is 2086S0129X – Vascular Surgery Physician; 4 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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