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DR. TIMOTHY MICHAEL FULLAGAR M.D. NPI 1629088364


NPI Information

NPI: 1629088364
Provider Name: DR. TIMOTHY MICHAEL FULLAGAR, M.D.
Classification: Neurological Surgery - 207T00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
701 MED TECH PKWY
SUITE 300
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 232-8301
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DR. Timothy Michael Fullagar, M.D. is a neurological surgery in Johnson City, TN with 38 years of experience. The provider is a neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. DR. Timothy Michael Fullagar, M.D. NPI is 1629088364. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

701 MED TECH PKWY
SUITE 300
JOHNSON CITY, TN
ZIP 37604-365
Phone: (423) 232-8301
Fax: (423) 232-8304

The NPI 1629088364 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/8/2006 and was last updated on 9/28/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207T00000XNeurological Surgery41401TENNESSEEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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