| Doctor Name: | DR. JACE PAUL FULLMER |
| NPI Number: | 1306145776 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 9415721-1204 |
| Business Practice Address: | 5121 S Cottonwood St Salt Lake City, UT - 841075701 |
| Business Phone Number: | 8015079700 |
| Business Fax Number: | |
| Mailing Address: | 5121 S Cottonwood St, SALT LAKE CITY |
| State: | UT |
| Postal Code: | 841075701 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/23/2011 |
| NPI Last Update Date: | 12/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207P00000X |
| License Number: | 9415721-1204 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Emergency Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |