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General NPI Number Information
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NPI Number | 1932593548
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Entity Type | Individual
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Provider Name | FULLER MCCABE MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2015
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 305 PAUL W BRYANT DR E
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City | TUSCALOOSA
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State | AL
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Zip | 35401-2055
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Country | US
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Telephone | 205-345-0192
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Fax |
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Provider Business Mailing Address
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Address Line | 305 PAUL W BRYANT DR E
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City | TUSCALOOSA
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State | AL
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Zip | 35401-2055
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Country | US
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Telephone | 205-345-0192
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Fax | 205-759-8784
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 27163
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License Number State | MS
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