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

Q: 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.

Q: What is Mark Fullmer's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Mark Fullmer was last updated on March 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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: July 19, 2026.

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

On this page

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

Open in Google Maps ↗