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DR. MARK ALLEN FULLMER M.D.
NPI 1457420853
Surgery in Provo, UT

Active since November 07, 2006
1055 N 300 W, SUITE 418, PROVO, UT 84604(801) 357-7100(801) 357-8100 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 7, 2023, May 16, 2021 (2 updates tracked since 2021).

About Dr. Mark Allen Fullmer M.d. NPPES

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

DR. MARK ALLEN FULLMER M.D. (NPI 1457420853) is an individual surgery provider in Provo, Utah, licensed in Utah (152450-1205) and active in the NPI registry since November 2006.

NPPES Registry Identity

NPI1457420853
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. MARK ALLEN FULLMERCredential: M.D.
Location Address1055 N 300 W, SUITE 418Provo, UT 84604-3344
Mailing Address1512 Renaissance Towne Dr Ste 200Bountiful, UT 84010-7517 · (385) 204-2722 · Fax (801) 734-3898
Phone(801) 357-7100
Fax(801) 357-8100
Sole ProprietorYes
Enumeration DateNovember 7, 2006
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
NPPES CertifiedMay 16, 2021
✔ NPI 1457420853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in UT · 152450-1205
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.
1055 N 300 W, Provo, UT 84604
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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.

UTAH SLEEP MEDICINE CENTER
Clinic/Center (Sleep Disorder Diagnostic)
1055 N 300 W, SUITE 402
PROVO, UT 84604
Utah County (801) 357-7878
JAMES THOMAS DANE MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1055 N 300 W, #110
PROVO, UT 84604
Utah County (801) 357-7081
DR. MAX FORD MCBRIDE PH.D.
Psychologist (Clinical)
1055 N 300 W, SUITE 414
PROVO, UT 84604
Utah County (801) 357-7757
INTERMOUNTAIN VEIN CENTER
Specialist
1055 N 300 W, #308
PROVO, UT 84604
Utah County (801) 379-6700
DR. PHILLIP LEE CHAFFIN JR. MD
Otolaryngology (Pediatric Otolaryngology)
1055 N 300 W, STE 401
PROVO, UT 84604
Utah County (801) 357-7499
GEORGE C GOURLEY, DO
Obstetrics & Gynecology (Gynecology)
1055 N 300 W, SUITE 305
PROVO, UT 84604
Utah County (801) 357-7190
CURTIS G THOMAS AUD
Audiologist
1055 N 300 W, STE 401
PROVO, UT 84604
Utah County (801) 357-7499
JENNY COY NP
Nurse Practitioner
1055 N 300 W, STE 401
PROVO, UT 84604
Utah County (801) 357-7499

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 Mark Fullmer's NPI number?

The NPI number for Mark Fullmer is 1457420853. It was assigned to this individual provider in the NPPES registry on November 7, 2006.

Where is Mark Fullmer located?

Mark Fullmer practices at 1055 N 300 W Suite 418, Provo, UT 84604. The listed phone number is (801) 357-7100.

What is Mark Fullmer'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 Mark Fullmer was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.