IndividualActive
Coy Fullen, DO
NPI 1902967243 · Family Medicine Physician · Plummer, ID
Provider details
- NPI number
- 1902967243
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- License
- BF4836978 (WA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
427 N 12th St
Plummer, ID 83851
Phone: (208) 686-1931
Fax: (208) 686-5133
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 388
Plummer, ID 83851-0388
Registry dates
- Enumerated
- 2006-12-12
- Last updated
- 2018-05-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.