Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Robert Montgomery Fuller

Individual provider Pediatrics Physician · NPI 1467255380

Robert Montgomery Fuller is a Pediatrics Physician in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2025.

Licensed in
MS
In the registry since
2025

Practice location Address checks out

2500 N State St
Jackson, MS 39216-4500
Phone: (601) 948-1000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence T-5609 (MS)

Record details

NPI number1467255380
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 27, 2025
Last updated in NPPESJuly 1, 2025
Certification dateJuly 1, 2025

Other providers in Jackson