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DR. JACK T. FULMER M.D.
NPI 1265592349
Surgery in Jacksonville, FL

Active since December 11, 2006
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224(904) 953-2000 Get Directions Write a Review

NPPES record last updated: September 24, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jack T. Fulmer M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACK T. FULMER M.D. (NPI 1265592349) is an individual surgery provider in Jacksonville, Florida, licensed in Florida (ME12908) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1265592349
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. JACK T. FULMERCredential: M.D.
Location Address4500 SAN PABLO RD SJacksonville, FL 32224-1865
Mailing Address4500 San Pablo Rd SJacksonville, FL 32224-1865 · (904) 953-2000
Phone(904) 953-2000
Sole ProprietorNo
Enumeration DateDecember 11, 2006
Last NPPES UpdateSeptember 24, 2007
✔ NPI 1265592349 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in FL · ME12908
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
4500 SAN PABLO RD S, Jacksonville, FL 32224
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Other Identifiers 3

Medicare UPIND61562FL
Other10030XFL · Medicare
Other10030FL · Blue Cross

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHERINE L WALSH PA-C/MPH
Physician Assistant
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
DR. JAMI ANN ROTHE KINNUCAN M.D.
Internal Medicine (Gastroenterology)
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
GLENN SHI MD
Orthopaedic Surgery
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
MICHELLE TULANG MD
Internal Medicine
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
RICARDO PAGAN MD
Hospitalist
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
CRYSTAL LYNN CRNA
Nurse Anesthetist, Certified Registered
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
LAUREN E FREED CRNA
Nurse Anesthetist, Certified Registered
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
MRS. MELINA VOLNER SOMMESE PA-C
Physician Assistant
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2594

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Fulmer's NPI number?

The NPI number for Jack Fulmer is 1265592349. It was assigned to this individual provider in the NPPES registry on December 11, 2006.

Where is Jack Fulmer located?

Jack Fulmer practices at 4500 San Pablo Rd S, Jacksonville, FL 32224. The listed phone number is (904) 953-2000.

What is Jack Fulmer's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

When was this NPI record last updated?

The NPPES record for Jack Fulmer was last updated on September 24, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.