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Mark Fullmer, M.D.
NPI 1457420853 · Surgery Physician · Provo, UT
Mark Fullmer, M.D. is a Surgery Physician provider in Provo, UT (NPI 1457420853).
Provider details
- NPI number
- 1457420853
- Entity type
- Individual
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 152450-1205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1055 N 300 W
Suite 418
Provo, UT 84604-3344
Phone: (801) 357-7100
Fax: (801) 357-8100
Street-level locationGet directions
Mailing address
1512 Renaissance Towne Dr Ste 200
Bountiful, UT 84010-7517
Registry dates
- Enumerated
- 2006-11-07
- Last updated
- 2023-03-07
- Certified
- 2021-05-16
Frequently asked questions
- What is Mark Fullmer's NPI number?
- Mark Fullmer's National Provider Identifier (NPI) is 1457420853, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mark Fullmer's specialty?
- Mark Fullmer is listed in the NPPES registry with a primary specialty of Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Mark Fullmer located?
- Mark Fullmer's practice location on file with NPPES is 1055 N 300 W, Provo, UT 84604-3344.
- What is Mark Fullmer's phone number?
- The practice phone number listed in the NPPES registry for Mark Fullmer is (801) 357-7100.
- Is Mark Fullmer's NPI active?
- Yes — Mark Fullmer's NPI (1457420853) is active in the NPPES registry as of the last update on 2023-03-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.