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Contact Information

PATRICK J FULLERTON, DO
6909 OLD HIGHWAY 441 S STE 222
MOUNT DORA, FL32757-7039
 Phone: 352-441-9803
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

208VP0000X 72 Physician/Pain Management
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for PATRICK J FULLERTON · (Male)

NPI # 1811039555
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 02/12/2007
Last updated 08/12/2025 - About 10 months ago
Sole proprietor 1 No
Identifiers
  • FL License # OS8087
  • FL Medicaid 015379100
  • FL Other OS8087 MEDICAL LICENSE NUMBER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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