Physician Compare National (NPI:1457440984)

HEALTHCARE PROVIDER: NORMAN EUGENE FULLER D.C.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1457440984
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0345234092
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111220000045
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FULLER
	Individual professional last name
Provider First Name	NORMAN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PALMER COLLEGE CHIROPRACTIC - DAVENPORT
	Individual professional's medical school
Graduation Year	1992
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	833 W COMMERCIAL DR
	Group Practice or individual's line 1 address
City	WASILLA
	Group Practice or individual's city
State	AK
	Group Practice or individual's state
Zip Code	996546937
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	020006
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MAT-SU REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y