DR. MARK ALLEN FULLMER (M.D.) – Surgery Physician, NPI 1457420853

DR. MARK ALLEN FULLMER (M.D.) is a healthcare provider. based in Provo, Utah. specializing in Surgery Physician. They hold the professional credentials M.D.. They hold a License No. 152450-1205 (UT). The NPI Number for DR. MARK ALLEN FULLMER (M.D.) is 1457420853

Main info

Male
Sole Proprietor
Name
DR. MARK ALLEN FULLMER (M.D.)
NPI
1457420853
Phone
(801) 357-7100
Address
1055 N 300 W
Enumeration Date
7 November 2006
Last Update Date
7 March 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for DR. MARK ALLEN FULLMER (M.D.)

  • 1055, North 300 West, North Park, Pleasant View, Provo, Utah County, Utah, 84604, United States

    SUITE 418

    PROVO, UT 846043344

    Phone: (801) 357-7100

    Fax: (801) 357-8100

    Type: Mailing

  • 1512 RENAISSANCE TOWNE DR STE 200

    BOUNTIFUL, UT 840107517

    Phone: (385) 204-2722

    Fax: (801) 734-3898

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $25.

Total Amount is formed as General ($25) + Research ($0) + Ownership ($0) = $25.

Last reported payment date: 2023-09-13 • Largest payer in this snapshot: Boston Scientific Corporation ($25).

Total Amount

$25

General + Research + Ownership

Payments

1

Total payment records

General Amount

$25

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-13

Latest reported date

Top Companies

Largest payers in this snapshot

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84604)

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Reviews

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Frequently asked questions

Is there an official ID for DR. MARK ALLEN FULLMER (M.D.) in U.S. healthcare records?
The official identifier for DR. MARK ALLEN FULLMER (M.D.) is NPI 1457420853.
Would DR. MARK ALLEN FULLMER (M.D.) appear as active to a payer?
You can treat DR. MARK ALLEN FULLMER (M.D.) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for DR. MARK ALLEN FULLMER (M.D.)?
At a glance, DR. MARK ALLEN FULLMER (M.D.) is tied to Surgery Physician. Clinical services aligned with this taxonomy classification.
Is DR. MARK ALLEN FULLMER (M.D.) associated with Provo?
Public fields place DR. MARK ALLEN FULLMER (M.D.) around Provo, Utah. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for DR. MARK ALLEN FULLMER (M.D.) is noted as November 7, 2006 where the registry provides it.

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